Article Summary
April 21, 2020
Positive result of Sars-Cov-2 in faeces and sputum from discharged patient with COVID-19 in Yiwu, China
Follow-up testing of 13 discharged COVID-19 patients revealed 2 patients continuously tested positive for SARS-CoV-2 even though sputum was negative, and 4 patients had positive sputum samples 5-14 days after discharge. Under present discharge criteria, the high presence of SARS-CoV-2 RNA indicates potential infectivity. The authors recommend adding a negative result from fecal testing to…
Specific ACE2 Expression in Small Intestinal Enterocytes may Cause Gastrointestinal Symptoms and Injury after 2019-nCoV Infection
This study summarizes clinical data from four recent studies involving clinical characteristics of COVID-19 to determine the incidence of GI symptoms and explore the potential mechanism of diarrhea and other GI manifestations of disease. Results reveal that ACE mRNA and proteins are highly expressed in the small intestine, which may mediate the invasion and amplification…
Diarrhea is associated with prolonged symptoms and viral carriage in COVID-19
This retrospective analysis of 84 patients with SARS-CoV-2 pneumonia in Wuhan found that duration of fever and shortness of breath in patients with diarrhea was significantly longer than those without, and that patients with diarrhea have a higher proportion of SARS-CoV-2 viral RNA detection in stool. Wei et al. (April 18, 2020). Diarrhea is associated…
Comparing rapid scoring systems in mortality prediction of critical ill patients with novel coronavirus disease
The authors evaluated the performance of the Modified Early Warning Score (MEWS) and Rapid Emergency Medicine Score (REMS) when applied to 138 critically ill COVID-19 patients. REMS was a better predictor of mortality among both age groups (<65 and 65+ years old), and could provide emergency clinicians with an effective adjunct risk stratification tool for…
Serological tests facilitate identification of asymptomatic SARS-CoV-2 infection in Wuhan, China
The authors report positive rates of COVID-19 tests based on nucleic acid testing, chest CT, and serological antibody tests in Wuhan, observing a 10% SARS-CoV-2 specific IgG positive rate from 1,402 tests. Combination of nucleic acid and serological testing might facilitate the detection of COVID-19 infection. Wu et al. (April 20, 2020). Serological tests facilitate…
Outcomes of hydroxychloroquine usage in United States veterans hospitalized with Covid-19
This retrospective analysis of 368 patients who had received hydroxychloroquine (with azithromycin or alone) explored the association between treatment and the primary outcomes of mechanical ventilation and death. No evidence was found of reduced risk of mechanical ventilation, and use of hydroxychloroquine alone was associated with an increased risk of overall mortality. These findings highlight…
False-Negative Results of Initial RT-PCR Assays for COVID-19: A Systematic Review
Arevalo-Rodriguez et al reviewed available evidence on false-negative RT-PRC results when testing for SARS-CoV-2 using 5 studies enrolling 957 patients in total. While cautious in interpretation due to potential bias and heterogeneity of findings, the authors report the pooled false-negative proportion of 0.085 (95% CI= 0.034-0.196) and reinforce the need for repeated testing in patients…
Development and Multicenter Performance Evaluation of The First Fully Automated SARS-CoV-2 IgM and IgG Immunoassays
Qian et al evaluated the clinical sensitivity of IgM and IgG SARS-CoV-2 antibody testing using 972 non-COVID-19 patients, 586 normal donors, and 503 RT-PCR-confirmed cases. IgM and IgG show clinical sensitivity of 85.88% and 96.62% respectively for confirmed SARS-Cov-2 infection with RT-PCR. These assays may add great value to nucleic acid testing. Qian et al….
Sequencing analysis of the spread of SARS-CoV2 in the Greater New York City Region
This analysis of 156 SARS-CoV-2 sequences from New York City showed that most samples were related to viral outbreaks in Europe, and suggest numerous seed transmissions and a period of unrecognized community spreading. Maurano et al. (April 21, 2020). Sequencing analysis of the spread of SARS-CoV2 in the Greater New York City Region. Pre-print downloaded…
Epidemiological and Genomic Analysis of SARS-CoV-1 2 in Ten Patients from a Mid-sized City outside of Hubei, China
This epidemiological and genomic analysis from 10 patients in Shaoxing led to an estimated average mutation rate of 1.37×10-3 nucleotide substitution per site per year, similar to other coronaviruses. The authors conclude that the moderate mutation rate lends hope to the development of an effective long-lasting vaccine. Chen et al. (April 21, 2020). Epidemiological and…
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