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October 28 | Daily COVID-19 LST Report

Epidemiology

· A review of data from the 2011-2016 National Health and Nutrition Examination Survey (NHANES; n=7744 participants) to estimate the proportion of the United States population with risk factors for severe COVID-19 found 73.7% had at least one risk factor (most commonly obesity [41%] and hypertension [50.1%]), while low-income individuals and those with less education typically had more risk factors (p<0.01).

· A comparative analysis by public health experts from Israel on crude case-fatality rates (CFR) within 7 countries found large differences in reported age distribution of COVID-19 cases and CFR variance, but minimal differences among pooled age-specific CFR, and CFR variance decreased significantly after age adjustment, suggesting that utilization of age-specific and age-adjusted COVID-19 CFR data may be more accurate than crude CFR when comparing between countries.

· Obstetricians from Shanxi Medical University in Taiyuan, China conducted a systematic review of studies (n=36) published between December 1, 2019 and June 10, 2020 on outcomes of COVID-19 in pregnancy and found less than 0.01% of samples from newborns born to women with COVID-19 were positive for SARS-CoV-2, however, 25.32% of infants were born prematurely (i^2=63.7%) and 35.87% of mothers were intubated (i^2=73.3%), with 4.95% admitted to the intensive care unit (i^2=68.3%).

Transmission & Prevention

· A cohort study where the forehead temperature of 101 healthy male and female employees of a hospital in Tyrol, Austria was measured upon entrance to the hospital and after several subsequent time points found that forehead temperatures were the lowest upon entrance into the hospital due to the cold outdoor climate (–5.5 °C and 0 °C) and did not reach a steady-state until approximately 60 minutes after entrance, suggesting that forehead temperatures may not be an effective screening tool for infectious disease such as COVID-19 in locations with a cold climate.

Management

· A placebo-controlled, double-blind randomized clinical trial of hospitalized COVID-19 positive patients not on mechanical ventilation (n=242) found that patients who received tocilizumab (n=161) had similar rates of death or intubation (HR 0.83, 95%CI 0.38-1.81), worsened condition (HR 1.11, 95%CI 0.59-2.1), and supplemental oxygen requirement (HR 0.94, 95%CI 0.67-1.3) compared to the non-treatment control group (n=81).

Adjusting Practice During COVID-19

· A letter to the editor proposes implementation of "Chronic COVID Syndrome (CCS)" as the appropriate nomenclature used in published work regarding the long term effects of COVID-19 infection, as well as a staging system based on the predominant organ involved in infection, so hospitals can anticipate complications and better clinically manage patients.

· A literature review conducted across various cardiovascular medical institutions throughout the United States aimed to refine previous American College of Cardiology's Sports and Exercise Cardiology recommendations on a conservative return-to-play approach with cardiac risk stratification for post-COVID-19 athletes, and to expand the approach to include the possibility of myocarditis and increased risk for sudden cardiac death during exercise despite a mild or asymptomatic infection.

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