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August 5, 2020
Challenges in Use of Saliva for Detection of SARS CoV-2 RNA in Symptomatic Outpatients
Landry et al. found that real-time RT-PCR of pure saliva samples had an overall sensitivity for SARS CoV-2 RNA detection of 85.7 % when compared to simultaneously collected nasopharyngeal swab samples. More than 33% of the saliva samples were initially too thick or stringy to be pipetted efficiently, requiring an additional sample preparation step before testing. The…
Evidence-Based Considerations Exploring Relations between SARS-CoV-2 Pandemic and Air Pollution: Involvement of PM2.5-Mediated Up-Regulation of the Viral Receptor ACE-2
A correlation analysis of air quality and COVID-19 incidence and mortality in Italy suggested that higher concentrations of fine particulate matter (PM2.5) corresponded temporally with higher COVID-19 incidence, mortality, and case fatality ratios across 110 geographic areas in Northern Italy. The infection rate tripled for PM2.5 levels increasing from 10 to 25 µg/m3 and the case fatality doubled for PM2.5 levels increasing from 10 to 22 µg/m3. The authors propose a potential mechanism for this observation due to…
Stepwise School Opening Online and Off-Line and an Impact on the Epidemiology of COVID-19 in the Pediatric Population
[pre-print, not peer reviewed] Yoon et al. observed no increase in pediatric COVID-19 cases following school re-openings in South Korea. School openings were delayed from March 2020. Instead, online classes began on April 9 and in-person classes started between May 20 to June 8 in four steps by different grades. As of July 11, among the…
August 4, 2020
Coronavirus Disease 2019 (COVID-19) Outbreak in a San Francisco Homeless Shelter
Imbert et al. report on an outbreak of COVID-19 in a San Francisco homeless shelter, during which 255 residents and 64 staff were present. An initial strategy of tracing bedmates of the first 2 cases and temperature checks and symptom screening of residents identified 7 additional cases. Subsequently, mass testing of 150 of 255 residents identified that 67% were positive, of which 48% were symptomatic at the time of testing. Of the 60 staff…
Determining the Optimal Strategy for Reopening Schools, the Impact of Test and Trace Interventions, and the Risk of Occurrence of a Second COVID-19 Epidemic Wave in the UK: A Modelling Study
Panovska-Griffiths et al. appplied the Covasim model (developed by the Institute for Disease Modeling) to simulate six scenarios for the UK representing a combination of school reopening strategies and contact tracing and testing coverage. Under full re-opening of schools, if 68% of contacts could be traced, 75% of symptomatic individuals would need to be tested (and positives isolated) to prevent a second wave. If…
The Risk and Prognosis of COVID-19 Infection in Cancer Patients: A Systematic Review and Meta-Analysis
A systematic review and meta-analysis (n=22 studies with 1,018 cancer patients) found the prevalence of cancer among patients was 2.1% (95% CI 1.3, 3%). Case fatality among these patients was 21.1% (95% CI 14.7, 27.6%). The probability for severe/critical disease was 45.4% (95% CI 37.4, 53.3%), for ICU admission was 14.5% (95% CI 8.5, 20.4%), and need for mechanical ventilation was 11.7% (95% CI 5.5,…
Symptom Relief Is Possible in Elderly Dying COVID-19 Patients: A National Register Study
Strang et al. used the Swedish Register of Palliative Care, which has national coverage, to compare symptoms and symptom control in the last week of life among patients dying of COVID-19 in nursing homes and hospitals (n=390) to registered deaths in similar settings in 2019 (n=46,698). They found breathlessness was more common in COVID-19 patients than the reference population, and in hospitals than in nursing homes. Relief of breathlessness,…
BMI Is Associated with Coronavirus Disease 2019 Intensive Care Unit Admission in African Americans
A cross-sectional study of African American patients with COVID-19 treated in a single tertiary care center (n=158) between March 12 and April 9 found older age (OR 1.07, 95% CI 1.03, 1.11), higher BMI (OR 1.12, 95% CI 1.05, 1.18) and lung disease (OR 3.1, 95% CI 1.4, 8.4) were significant risk factors for ICU admission. In contrast…
SARS-CoV-2 Seroprevalence Across a Diverse Cohort of Healthcare Workers
[pre-print, not peer-reviewed] A study among workers at a multi-site healthcare system in LA County estimated SARS-CoV-2 antibody seroprevalence post–stratified on demographic group (n=15,000 invited; 6,062 participated). Overall seroprevalence was 4.1% (95% CI 3.1, 5.7%), with lower estimates in older workers (aOR = 0.8, 95% CI 0.7, 0.9) and higher estimates in Hispanic workers (5.7%; 95% CI 3.9, 8.3%; aOR = 1.8, 95% CI 1.3, 2.4). Significantly higher estimates were also observed for African American race (aOR=1.8, 95% CI 1.1, 2.9), and for workers…
Antibody Response against SARS-CoV-2 Spike Protein and Nucleoprotein Evaluated by 4 Automated Immunoassays and 3 ELISAs
To measure sensitivity of antibody response against SARS-CoV-2 spike protein and nucleoprotein, 4 automated immunoassays (Roche Abbott, Diasorin, and Snibe) and 3 ELISAs (2 from Euroimmun and Mikrogen) were evaluated using samples from 114 patients with moderate, severe, or critical COVID-19 and 113 pre-pandemic samples. Three weeks post-symptom onset, sensitivity was 100%. Specificity varied from 94.7% to 100%; using a ROC curve to estimate cut-offs corresponding to specificities of 95% and 97.5%, the Roche assay (all…
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