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November 17 | Daily COVID-19 LST Report


Epidemiology

· Persistent fatigue following SARS-CoV-2 infection is common and independent of severity of initial infection according to one study. Immunologists and infectious disease specialists at St. James’s Hospital in Dublin, Ireland examined prevalence of post-COVID-19 fatigue in 128 patients who had recovered from COVID-19 using the Chalder Fatigue Score (CFQ-11). They found 52.3% (67/128) of participants met the criteria for fatigue at a median of 10 weeks following initial symptoms and fatigue was associated with female gender and preexisting depression/anxiety, but data showed no association between total CFQ-11 score and age, disease course, or laboratory measures of inflammation. These results suggest post-COVID-19 fatigue may be more prevalent than previously understood, and authors advocate for further research among those with previous SARS-CoV-2 infection.

· An Outbreak of COVID-19 on an Aircraft Carrier Spreads Fast. Public Health experts affiliated with the U.S. Navy conducted an epidemiologic investigation of the COVID-19 outbreak on the U.S.S. Theodore Roosevelt. Results showed that of the 26.6% of crew (1271) who tested positive for SARS-CoV-2 via RT-PCR, nearly half were asymptomatic, more than 30% of symptomatic cases initially reported having cough and headache, and among 1331 suspected or confirmed cases, 23 were hospitalized, 4 received intensive care, and 1 died. The authors suggest that the confined and densely populated areas, as well as the relatively high number of asymptomatic cases, may have contributed to the fast spread of the COVID-19 cases on the Aircraft Carrier.

· Ultrasound Imaging Findings of Acute Testicular Infection in Patients With COVID-19 were explored by a team from the Department of Ultrasound Imaging at Wuhan University Renmin Hospital. It was a retrospective study of 142 male patients hospitalized with COVID-19 who underwent bedside scrotal ultrasound. They found 32 patients (22.5%) presented with findings of acute testicular inflammation: 10 with acute orchitis, 7 with acute epididymitis, 15 with epididymo-orchitis. There was a higher frequency in men >80 years-old (p=0.003) and in the severe COVID-19 group (p=0.002). Authors suggest SARS-CoV-2 may infect the testicles and/or epididymis and recommend clinicians be aware of these genitourinary manifestations.

Transmission & Prevention

· United Kingdom’s definitions of vitamin D sufficiency and recommended supplement dose are set too low. UK physicians in Infectious Disease, Endocrinology, Respiratory, and Gerontology conclude that the original threshold goal for vitamin D sufficiency, 25nmol/L, is too low and not evidence-based, suggesting that it should instead be set at 50 nmol/L and recommend supplementation with 800 IU per day. They speculate vitamin D deficiency as a risk factor for COVID-19 and advocate for an increase in the recommended Vitamin D supplement dose.

Silver Linings

· What was the impact of non-COVID-19 deaths after social distancing in Norway? American public health experts analyzed the effect of social distancing in Norway on non-COVID-19 deaths during March 16-May 18, 2020 using the Human Mortality Database’s Short-term Mortality Fluctuations data series. They compared non-COVID-19 deaths in Norway during the nine-week period to expected deaths, based on historical Norwegian data and non-COVID-19 deaths in Sweden, by using the Box-Jenkins time series method and found 430 fewer non-COVID-19 deaths in Norway than expected. Authors suggest social distancing carries mortality benefits beyond COVID-19 prevention and recommend in-depth analysis of such measures on health indicators when considering risks and benefits of public health policies.


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