Article Summary
June 23, 2020
Decrease in Acute Coronary Syndrome Presentations during the COVID-19 Pandemic in Upstate New York
A multi-center study found admissions for acute coronary syndrome among COVID-19 negative patients dropped by 41% during March/April 2020 (n=67), compared with the same period in 2019 (n=113). A greater proportion of patients with non-ST elevation myocardial infarction presented >24 hours after onset of symptoms in 2020 than in 2019 (36% vs. 27%, p=0.033). The authors conclude that if this decline is due to…
Effectiveness and Safety of Glucocorticoids to Treat COVID-19: A Rapid Review and Meta-Analysis
A meta-analysis (n=23 studies, 1 RCT and 22 cohort studies; 13,815 patients) found the use of glucocorticoid steroids was associated with a non-significant increase in mortality (RR=2.00, 95%CI 0.69, 5.75) and duration of hospitalization (increase of 2.4 days, 95%CI 1.4, 3.4) but significantly lower duration of fever (-3.23 days, 95%CI -3.56, -2.90). Heterogeneity was high across the included studies…
Outcomes among HIV-Positive Patients Hospitalized with COVID-19
A retrospective cohort study that matched 21 HIV-positive COVID-19 patients (median CD4 count 298/uL, <200/uL for 6 patients; all on HAART) to 42 HIV-negative COVID-19 patients hospitalized at New York University Langone Health found those with HIV co-infection had a non-significantly higher risk of changes on chest CT (91% vs 64%), ICU admission (29% vs 17%), mechanical ventilation (24% vs 12%), death…
Effect of Dexamethasone in Hospitalized Patients with COVID-19 Preliminary Report
[pre-print, not peer reviewed] Horby et al. present preliminary results from the open-label randomized RECOVERY trial that found reduced mortality among COVID-19 patients treated with oral dexamethasone (6mg once daily for up to 10 days). Patients in the dexamethasone arm had a 17% lower rate of death by 28 days than those in the control arm (aRR=0.83; 95%CI 0.74, 0.92), with the strongest effect in…
Persistence of SARS-CoV-2 in the Environment and COVID-19 Transmission Risk from Environmental Matrices and Surfaces
Carraturo et al. reviewed the survival of SARS-CoV-2 in the environment and found that survival of the virus is likely to be very low in contaminated food, on inanimate surfaces, and in water, wastewater, sludge, or bio-solid waste contaminated by feces. They note that while transmission risks may be higher for some occupational groups (e.g., wastewater treatment workers), with appropriate PPE use and disinfection protocols this…
Respiratory Virus Shedding in Exhaled Breath and Efficacy of Face Masks
Use of a surgical mask significantly reduced the proportion of droplets and aerosols with detectable virus among children and adults with confirmed seasonal coronavirus and seasonal influenza infection. Among 17 patients with seasonal coronavirus, virus was detected in 30% of droplets and 40% of aerosols among those randomized to not wear a surgical mask compared to 0% detection in both droplets and aerosols of…
June 22, 2020
Western Washington State COVID-19 Experience: Keys to Flattening the Curve and Effective Health System Response
The Western WA COVID-19 Expert Panel seeks to identify factors contributing to the effective health system disaster response in western Washington State. Six key themes were identified: (1) Early communication and coordination among stakeholders; (2) Regional coordination of the healthcare system response; (3) Rapid development and access to viral testing; (4) Proactive management of long-term care & skilled nursing facilities; (5) Proactive management of vulnerable populations; (6) Effective physical distancing in the…
Characteristics Associated With Out-of-Hospital Cardiac Arrests and Resuscitations During the Novel Coronavirus Disease 2019 Pandemic in New York City
Lai et al. conducted a population-based, cross-sectional study among 5,325 patients who underwent emergency resuscitation by New York City 911 emergency medical responders. They found that out-of-hospital cardiac arrests and deaths during the COVID-19 pandemic (March 1-April 25, 2020) significantly increased compared with the same period in 2019 (4.75/million vs. 1.59/million), and were associated with older age (mean 72 vs. 68 years), nonwhite race/ethnicity (20%…
Nonrelocatable Occupations at Increased Risk During Pandemics: United States, 2018
Baker summarized data from the 2018 US Bureau of Labor Statistics and reported that 75% (108.4 million) of US workers are employed in occupations that are challenging to do from home, including health care, manufacturing, retail, and food services, which also tend to have lower pay. The author concludes that the stress experienced by lower-income groups, coupled with job insecurity, could…
Global, Regional, and National Estimates of the Population at Increased Risk of Severe COVID-19 Due to Underlying Health Conditions in 2020: A Modelling Study
Clark et al. used prevalence data from two large multi–morbidity studies and estimated that 1.7 billion (uncertainty interval (UI) 1.0–2.4) people, comprising 22% (UI 15–28) of the global population, have at least one underlying health condition that puts them at increased risk of severe COVID-19. The increased risk was highest in countries with older populations, African countries with high HIV/AIDS prevalence, and…
Previous page Next page