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September 30 | Daily COVID-19 LST Report


Epidemiology

· Age-specific COVID-19 case-fatality rates show no evidence of changes over time. Members of the University Vita-Salute San Raffaele School of Medicine in Milan, Italy looked at national-level COVID-19 surveillance data in Italy and found that case fatality rates were 3% in people younger than 60 years compared to 30% in people over 80 years old. This is consistent with higher rates of chronic comorbidities in older populations. These fatality rates remaining consistent over 4 months of monitoring suggests that COVID-19 mortality has not improved or worsened, and younger age groups tend to have less severe COVID-19 outcomes.

Adjusting Practice During COVID-19

· Ocular findings in COVID-19 patients with severe systemic disease, including conjunctival congestion, epiphora, and chemosis, appeared to be common in a review by an ophthalmologist from the Department of Ophthalmology, John Hopkins University School of Medicine. Citing a study of 276 patients admitted to the hospital with COVID-19 in Hubei, China reporting that their eyeglass usage was lower than the general population, the ophthalmologist hypothesizes the possibility of ocular transmission of SARS-CoV-2 and encourages use of personal protective equipment (face shield, goggles, eyeglasses) to prevent ocular transmission during this pandemic. R&D: Diagnosis & Treatments

· A web visualization tool using T cell subsets as the predictor to evaluate COVID-19 patient's severity: A study conducted at the Wuhan Pulmonary Hospital analyzing COVID-19 positive patients (n=340) found T-cell subsets analyzed upon initial diagnosis (Total T-cells, Helper T-cells [TH], Suppressor T-cells [TSC], and TH/TSC) differed significantly in patients that were discharged (n=310) compared to death cases (n=30); while age, underlying disease status, Helper T-cell count, and TH/TSC ratio were significant predictors of either death or discharge, but a well-functioning immune system at time of hospitalization indicated a higher chance of recovery. These findings suggest T-cell subset monitoring may be useful to detect changes in condition and predict prognosis of patients with COVID-19. · Targeting the endolysosomal host-SARS-CoV-2 interface by clinically licensed functional inhibitors of acid sphingomyelinase (FIASMA) including the antidepressant fluoxetine showed that fluoxetine successfully inhibits the entry/propagation of SARS-CoV-2 in cell culture without cytotoxic effects. It also exhibits antiviral activity against two subtypes of Influenza A virus via a mechanism that impairs endolysosomal acidification and leads to accumulation of cholesterol in endosomes. Similar effects were also observed with amiodarone and imipramine, two other FIASMA drugs. These findings suggest endolysosomal lipid balance as a potential efficacious FIASMA drug target of the host-virus interface for SARS-CoV-2 and other enveloped viruses.

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