COVID-19 Literature Situation Report March 26, 2020

• This study suggests that early adoption of social distancing is more effective than delayed implementation, even of highly restrictive measures, implying that there may be a threshold of public health interventions after which a decline in death rates begins to occur. 
• This method may be helpful in planning for and monitoring the relaxation of social distancing and evaluating the effectiveness of implementation in individual countries.

Pike & Saini (Mar 25, 2020). An international comparison of the second derivative of COVID-19 deaths after implementation of social distancing measures. Pre-print downloaded Mar 26 from https://doi.org/10.1101/2020.03.25.20041475 

• This case study presents two false negative results of real-time RT-PCR which is regarded as the gold standard method for confirming SARS-CoV-2 infection. The study discusses using complementary approaches such as computed tomography (CT) in combination with rRT-PCR to achieve more reliable diagnosis. 

Li et al. (Apr 2020). False-Negative Results of Real-Time Reverse-Transcriptase Polymerase Chain Reaction for Severe Acute Respiratory Syndrome Coronavirus 2: Role of Deep-Learning-Based CT Diagnosis and Insights from Two Cases. KJR. https://doi.org/10.3348/kjr.2020.0146 

• Reeves et al outline the design and implementation of EHR based rapid screening processes, laboratory testing, clinical decision support, reporting tools, and patient-facing technology related to COVID-19; and highlight the essential role of EHR in supporting clinical needs of a health system during this outbreak. 

Reeves et al. (Mar 24, 2020). Rapid Response to COVID-19: Health Informatics Support for Outbreak Management in an Academic Health System. J Am Med Inform Assoc. https://doi.org/10.1093/jamia/ocaa037

• This study presents clinical characteristics of COVID-19 from 9 children and their families, indicating that new control measures should include rapid medical assessment and removal of cases from home and increased awareness of the importance of protective measures after symptom onset.

Su et al. (Mar 25, 2020). The different clinical characteristics of corona virus disease cases between children and their families in China – the character of children with COVID-19. Emer Microbes and Infect. https://doi.org/10.1080/22221751.2020.1744483

• In this cohort study of 416 patients from 1 hospital in Wuhan, the authors find that cardiac injury was a common condition among patients hospitalized with COVID-19 and was associated with a higher risk of in-hospital mortality. 
• Although the exact mechanism of cardiac injury needs to be further explored, the findings highlight the need to consider this complication in COVID-19 management.

Shi et al. (Mar 25, 2020). Association of Cardiac Injury With Mortality in Hospitalized Patients With COVID-19 in Wuhan, China. JAMA Cardio. https://doi.org/10.1001/jamacardio.2020.0950 

• This retrospective study of 788 COVID-19 patients, 136 of whom were older patients (60+ years), from Wuhan describes the specific epidemiological and clinical features of older COVID-19 patients.
• The study finds that these older patients were more likely to: be female gender; have high body temperature; show familiar clustering; have co-existing basic diseases, dyspnea, or lymphocytopenia; develop severe/critical infection type and be admitted to ICU; have higher levels of AST, CK, LDH, CRP; and have lower levels of haemoglobin and albumin when compared to the  younger patients.

Lian et al. (Mar 25, 2020). Analysis of Epidemiological and Clinical features in older patients with Corona Virus Disease 2019 (COVID-19) out of Wuhan. Clin Infec Dis. https://doi.org/10.1093/cid/ciaa242 

• Sun et al share results from 4 prediction models that included rapidly ascertainable clinical findings, clinical tests, demographic variables and exposure risk factors. 
• These could be used to identify individuals with a higher probability for COVID-19 and enable prioritization of PCR-testing and containment efforts. Basic laboratory test results were crucial to prediction models.

Sun et al. (Mar 25, 2020). Epidemiological and Clinical Predictors of COVID-19. Clin Infec Dis. https://doi.org/10.1093/cid/ciaa322

• The COVID-19 Acute and Intensive Care Resource Tool (CAIC-RT) is capable of estimating the maximum daily number of incident COVID-19 cases that a Healthcare system could manage based on age-adjusted case distribution and severity data from the US. 
• This tool can help planners determine a sustainable threshold for resource utilization, and is available online at https://caic-rt.shinyapps.io/CAIC-RT. 

Giannakeas et al. (Mar 25, 2020). Estimating the maximum daily number of incident COVID-19 cases manageable by a healthcare system. Pre-print downloaded Mar 26 from https://doi.org/10.1101/2020.03.25.20043711 

• This report provides detailed information on the “ABCD’s” of the COVID-19 pandemic for geriatrics healthcare providers: Awareness of potential key clinical differences of COVID-19 in this population; quickly initiating appropriate behaviors to clinically manage the infection in LTCFs; implementing containment strategies to disrupt further spread of the virus; and being knowledgeable about the decisions being made at the local, state, and federal level. 

D’Adamo et al. (Mar 25, 2020). Coronavirus Disease 2019 in Geriatrics and Long-term Care: The ABCDs of COVID-19. J Am Geriatric Soc. https://doi.org/10.1111/jgs.16445 

• Ranney et al share several reasons that may have led to the critical shortage of PPE and ventilator supply in the US, and emphasize that a multipronged strategy requiring a concerted approach from local, state and national governments, private sectors and healthcare providers is necessary. 

Ranney et al. (Mar 25, 2020). Critical Supply Shortages — The Need for Ventilators and Personal Protective Equipment during the Covid-19 Pandemic. NEJM. https://www.nejm.org/doi/full/10.1056/NEJMp2006141