Article Summary
August 3, 2020
Vertical Transmission of COVID-19: A Systematic Review and Meta-Analysis
Kotlyar et al. pooled results of from 38 studies with 936 neonates to investigate SARS-CoV-2 vertical transmission. They found that the proportion of vertical transmission based on RNA PCR results from infant nasopharyngeal swabs was 3.2% (95%CI 2.2-4.3%). The neonatal serology (IgM) was positive in 3.7% (3/82). The authors note that the majority of mothers in their sample were likely infected during the third trimester of pregnancy, and that the risk of vertical transmission as…
Drug Treatments for Covid-19: Living Systematic Review and Network Meta-Analysis
A network meta-analysis of 23 RCTs evaluating treatments for COVID-19 found that glucocorticoids were the only intervention with evidence for a reduction in mortality compared with standard care (risk difference 37 fewer per 1000 patients, 95%CI 11-63) and need for mechanical ventilation (31 fewer per 1000 patients, 95%CI 9-47). Three drugs might reduce symptom duration compared with standard care: hydroxychloroquine (mean difference -4.5…
Utility of Repeat Testing for COVID-19: Lab Stewardship When the Stakes Are High
There may be little benefit of repeat SARS-CoV-2 PCR testing within 7 days after a negative test in patients who present early in their illness in a low-prevalence setting. Among 275 patients with initially negative (94%) or inconclusive (6%) nasopharyngeal PCR tests in Omaha, Nebraska who were tested serially between March-April 2020, only 1 (1/275) was positive on the 2nd test, and only 1…
Trends in Emergency Department Visits and Hospital Admissions in Health Care Systems in 5 States in the First Months of the COVID-19 Pandemic in the US
Jeffery et al. examine daily emergency department (ED) visits and hospital admission rates of 24 EDs in Colorado (n=4), Connecticut (n=5), Massachusetts (n=5), New York (n=5), and North Carolina (n=5) from January 1 to April 30, 2020 and temporal associations with the onset of local COVID-19 case escalations. Compared to the annual ED volume before the COVID-19 pandemic, ED visits…
Seroprevalence of SARS-CoV-2 and Infection Fatality Ratio, Orleans and Jefferson Parishes, Louisiana, USA, May 2020
Among 2,640 individuals (61% White) in Louisiana, USA, the weighted SARS-CoV-2 exposure rate was 8%. Seroprevalence was highest (10%) in Black participants, followed by multiracial (7%), Asian (6%), and White (5%) participants. The infection fatality ratio was 1.6%, similar for White (1.6%), Black (1.7%), and multiracial (1.4%) persons, but was significantly lower for Asian persons (0.6%). Feehan et al. (July 30, 2020). Seroprevalence…
In-Flight Transmission Cluster of COVID-19: A Retrospective Case Series
Yang et al. described a case series of 12 people who likely acquired SARS-CoV-2 on a 5-hour flight carrying 325 passengers and crew members. All passengers and crew were asymptomatic and without fever at the time of boarding. A single passenger was found to be febrile on arrival in China and tested positive for SARS-CoV-2. Consequently, all passengers and crew were quarantined and monitored for 14 days. Eleven additional passengers subsequently tested positive for SARS-CoV-2; no…
Household Transmission of SARS-CoV-2 a Systematic Review and Meta-Analysis of Secondary Attack Rate
[Preprint, not peer-reviewed] Madewell et al. performed a meta-analysis of 40 studies of SARS-CoV-2 household secondary attack rate (SAR). Overall, the estimated mean SAR for household contacts was 19% (95%CI 15%–23%) and family contacts was 18% (13%–35%), both with significant heterogeneity. SARs were significantly higher from symptomatic index cases than asymptomatic index cases (20% vs. 1%), to adult contacts than to child contacts…
July 31, 2020
Findings from a Probability-Based Survey of U.S. Households about Prevention Measures Based on Race, Ethnicity, and Age in Response to SARS-CoV-2
Self-reported individual behaviors to protect against SARS-CoV-2 exposure (e.g. wearing a facemask, maintaining physical distance from others, etc.) were nearly identical across white, African American, and Latino respondents in a nationally representative survey (n=1,395) of American households. Relative to white participants, African American and Latino participants were less likely to install an app that asked…
When Is SARS-CoV-2 in Your Shopping List?
Using agent-based models, Hernandez-Mejia et al. test the effects of various distancing rules and population sizes on the transmission of SARS-CoV-2 in a small- to medium-size supermarket. Policies that require at least 1 meter (3.3 feet) between shoppers and limit the number of shoppers to 15 in a store of about 30 m by 16…
Decontamination and Reuse of Surgical Masks and N95 Filtering Facepiece Respirators during COVID-19 Pandemic: A Systematic Review
Seresirikachorn et al. evaluated the effectiveness of existing decontamination methods of surgical masks and N95 respirators with a systematic review of 15 studies published before April 11, 2020 that described 14 decontamination methods. They find a low level of evidence supporting the use of four of the methods for decontamination and reuse of N95 masks, including ultraviolet germicidal irradiation, moist heat,…
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