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October 2 | Daily COVID-19 LST Report

Epidemiology

· An analysis of 235 COVID-19 patients found a statistically significant association between sufficient Vitamin D levels (≥ 30ng/mL) and reduced disease severity, reduced hypoxia, reduced in-hospital mortality, increased lymphocyte percentage, and reduced CRP. Vitamin D sufficiency may reduce cytokine storm and overall immune response, clinically implicating Vitamin D sufficiency as a potentially key factor in reduced COVID-19 associated morbidity and mortality.


Understanding the Pathology

· A case study describes a 16-year-old male with COVID-19 who displayed cutaneous pityriasis rosea involving the trunk, oral hard and soft palates and was found to have positive serology titers for Epstein Barr virus (EBV), human herpes virus-7 (HHV-7), and human herpes virus-6 (HHV-6), with high avidity IgG against EBV and HHV-6, illustrating reactivation of latent infections. This suggests that SARS-CoV-2 infection and/or its inflammatory sequela may trigger reactivation of multiple latent infections, possibly contributing to the cutaneous manifestation in this case and the severe course of COVID-19 overall.

Transmission & Prevention

· Contract tracing data collected by the CDC from two counties in North Carolina found that 48% of COVID-19-positive individuals in Mecklenburg county and 35% in Randolph county reported no contacts, and from contacts that were named, 25% in Mecklenburg and 48% in Randolph could not be reached by phone after several attempts, suggesting the need for improved population engagement as well as punctuality in contact tracing to help control the spread of COVID-19 in the community.

Adjusting Practice During COVID-19

· Researchers in the United Kingdom and Sweden assessed the potential of SARS-CoV-2 droplet transmission (≤5 microns) via pulmonary function tests (PFTs) from healthy volunteers (n=33) and found that the highest amount of particles came from uncoordinated involuntary coughing, while relatively minute amounts came from coordinated voluntary breathing, suggesting that adaptation to PFT maneuvers to decrease time of breath holding and avoiding full expiration to reduce cough reflex would reduce droplet release.

· A 10-day randomized study of 208 individuals to evaluate the impact of performing activities that satisfy basic psychological needs (i.e. autonomy, competence, relatedness) during the COVID-19 outbreak found that individuals within the "basic psychological need-satisfying activities" intervention had increased need satisfaction and overall well-being and decreased perceived frustration and stress as compared to the control group.


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