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June 18, 2020
Real-Time Reverse Transcription Loop-Mediated Isothermal Amplification for Rapid Detection of SARS-CoV-2
Lau et al. developed a reverse transcription loop-mediated isothermal amplification (RT-LAMP) assay for rapid detection of SARS-CoV-2. In comparison to the RT-qPCR assay, the investigators reported that the RT-LAMP assay was 2.5 times faster and had a clinical sensitivity and specificity of 100%. However, the RT-LAMP assay had a 5-fold higher limit of detection, Lau et al. (June 3, 2020). Real-Time Reverse Transcription…
GLUCOCOVID A Controlled Trial of Methylprednisolone in Adults Hospitalized with COVID-19 Pneumonia
[pre-print, not peer reviewed] In a partially randomized open-label trial among patients hospitalized with COVID-19 pneumonia (n=85), methylprednisolone was associated with a reduced risk of death, ICU admission, or non-invasive ventilation (RR =0.55, 95% CI: 0.33-0.91). Corral et al. (June 18, 2020). GLUCOCOVID A Controlled Trial of Methylprednisolone in Adults Hospitalized with COVID-19 Pneumonia. Pre-print downloaded June 18 from https://doi.org/10.1101/2020.06.17.20133579
Asymptomatic SARS-CoV-2 Infection and COVID-19 Mortality during an Outbreak Investigation in a Skilled Nursing Facility
Patel et al. conducted an outbreak investigation at a skilled nurse facility in Illinois on March 15 and followed 126 residents tested for COVID-19 for 30 days. Of the 33 confirmed cases at the beginning, 58% were symptomatic, 39% remained asymptomatic, and 3% developed symptoms over follow-up. The 30-day probability of death among cases was…
Measure What Matters: Counts of Hospitalized Patients Are a Better Metric for Health System Capacity Planning for a Reopening
Kashyap et al. used data from Stanford University medical facilities between March 2 and April 11, 2020 to measure to the impact of Shelter-In-Place orders on hospital utilization. They observed a marked slowdown in the hospitalization rate within ten days of Shelter-In-Place orders and a shift toward younger ages among COVID-19 patients. The authors discuss that current published prediction models use case counts that do not account for the…
June 17, 2020
Effectiveness of Isolation, Testing, Contact Tracing, and Physical Distancing on Reducing Transmission of SARS-CoV-2 in Different Settings
A mathematical model that stratified individual-level transmission by setting (household, work, school, or other) and used BBC pandemic data from over 40,000 UK participants found that a high proportion of cases would need to self-isolate and a high proportion of their contacts would need to be traced to halt the epidemic, in the absence of other measures. These measures would be more likely…
Olfactory and Gustatory Dysfunction as an Early Identifier of COVID-19 in Adults and Children: An International Multicenter Study
Among 394 patients positive for SARS-CoV-2 by PCR in five tertiary care hospitals in Europe and China, 41% reported disorders of taste or smell, with higher prevalence in the European cohorts than the Chinese cohort. Additionally, 10% reported disorders of taste or small as their only COVID-19 symptoms, and 19% reported these symptoms preceded their other symptoms. Qiu et al. (June 2020). Olfactory and Gustatory Dysfunction as…
Clinical Immunological and Virological Characterization of COVID-19 Patients That Test Re-Positive for SARS-CoV-2 by RT-PCR
[pre-print, not peer reviewed] Among 619 discharged COVID-19 cases in Guandong, China, where two consecutive negative tests are required before discharge and all discharged cases are isolated in designated hotels and sampled at a minimum of 7 and 14 days after discharge, 87 tested positive by RT-PCR during isolation. These individuals had robust antibody response and were negative on viral culture and evidence of degradation of the virus genome was…
Characteristics Associated with Hospitalization Among Patients with COVID-19 — Metropolitan Atlanta, Georgia, March–April 2020
An analysis of 220 hospitalized and 311 non–hospitalized COVID-19 patients in Atlanta found older age, black race, diabetes, lack of insurance, male sex, smoking, and obesity were independently associated with hospitalization. Killerby et al. (June 17, 2020). Characteristics Associated with Hospitalization Among Patients with COVID-19 — Metropolitan Atlanta, Georgia, March–April 2020. MMWR. Morbidity and Mortality Weekly Report. https://doi.org/10.15585/mmwr.mm6925e1
A Predictive Tool for Identification of SARS-CoV-2 PCR-Negative Emergency Department Patients Using Routine Test Results
Joshi et al. built a predictive tool for identifying SARS-CoV-2 PCR-negative emergency department patients based on sex and components of a complete blood count (a routinely-conducted test). Across a range of specificities, they found the average negative predictive value (NPV) to be 98% when validated on a northern California sample (41 positive, 495 negative). Applying the Northern California-defined threshold to…
Diagnosing COVID-19 in the Emergency Department: A Scoping Review of Clinical Exam, Labs, Imaging Accuracy and Biases
A scoping review of the accuracy of diagnostic approaches for COVID-19 in emergency department settings included 87 studies through May 5, 2020. The review concluded that report of fever and loss of smell and taste were the most helpful features to distinguish COVID-19 patients from those with similar illnesses and that a low white blood cell count is the most common lab abnormality. Sensitivity of testing by rRT-PCR in the emergency department was 60%-78%. CT scanning…
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