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Topic: Clinical Characteristics and Health Care Setting
July 24, 2020
Symptom Duration and Risk Factors for Delayed Return to Usual Health Among Outpatients with COVID-19 in a Multistate Health Care Systems Network — United States, March–June 2020
A telephone survey of non-hospitalized symptomatic COVID-19 patients found that illness can be prolonged, even among young adults without underlying chronic medical conditions. Among 274 symptomatic COVID-19 patients interviewed 14-21 days after diagnosis, 65% percent had returned to their usual state of health a median of 7 days (IQR 5-12 days) after testing, while the 35% had not yet returned to their usual…
Presence of Genetic Variants Among Young Men With Severe COVID-19.
A rare genetic mutation was identified in two sets of brothers who had severe COVID-19 disease. A case series reported by van der Made et al. included two sets of brothers under age 35 (mean age 26) without pre-existing medical conditions who were hospitalized with severe COVID-19 in the Netherlands. All four men required mechanical ventilation in…
July 23, 2020
Estimated County-Level Prevalence of Selected Underlying Medical Conditions Associated with Increased Risk for Severe COVID-19 Illness — United States, 2018
Based on data from the 2018 Behavioral Risk Factor Surveillance System (BRFSS) survey, the median county prevalence of any of five underlying medical conditions (chronic obstructive pulmonary disease, heart disease, diabetes, chronic kidney disease, and obesity) that are associated with increased risk for severe COVID-19 disease was 47% across 3,142 U.S. counties. While the total number of those with co-morbidities follows the overall population distribution, the prevalence of co-morbidities is higher in the southeastern United States and…
The Contribution of the Age Distribution of Cases to COVID-19 Case Fatality Across Countries: A 9-Country Demographic Study
In a cross-sectional study using population-based data on COVID-19 cases and deaths in 9 countries, Sudharsanan et al. observed an overall large variation in case-fatality. The highest case-fatality was reported in Italy (9.3%), and the lowest in Germany (0.7%). Adjustment for the age distribution of cases explains 66% of the between-country variation. The resulting age-standardized median…
Risk Factors Associated With Mortality Among Residents With Coronavirus Disease 2019 (COVID-19) in Long-Term Care Facilities in Ontario, Canada
Based on a cohort study among 627 long-term care (LTC) facilities in Ontario, Canada, the incidence of deaths related to COVID-19 was 13-fold higher among LTC residents compared to adults older than 69 years living in the community. This excess risk increased from 8-fold to 87-fold between March 29 and April 11. Infection among LTC staff was associated with death among residents with a 6-day lag. Fisman et al….
July 22, 2020
Proportion of Asymptomatic Coronavirus Disease 2019 (COVID‐19): A Systematic Review and Meta‐analysis
A systematic review (41 studies, 50,155 cases) found a pooled estimate that 16% of SARS-CoV-2 cases are asymptomatic across all age groups, with a higher percentage of asymptomatic children (28%). In a subset of initially asymptomatic patients (n=180) who were followed over time, 49% subsequently developed symptoms. The authors noted significant heterogeneity between study estimates of these measures. He et al. (July 21, 2020). Proportion of Asymptomatic Coronavirus Disease 2019 (COVID‐19): A Systematic Review…
July 21, 2020
SARS-CoV-2 in Pregnancy: Characteristics and Outcomes of Hospitalized and Non-Hospitalized Women Due to COVID-19
Barbero et al. report findings from a retrospective cohort study of all women diagnosed with SARS-CoV-2 infection during pregnancy or the postpartum period (n=91) in a tertiary care center in Spain. COVID-19 symptoms were the presenting complaint in 62% of patients. Forty patients (44%) developed pneumonia, 46% were hospitalized, and 4 required ICU admission, which was double the hospitalization (15.8-21.9%) and ICU admission (1.3-2.2%) rate for non-pregnant…
Symptom Clusters in Covid19 A Potential Clinical Prediction Tool from the COVID Symptom Study App
[pre-print, not peer-reviewed] Sudre et al. present data from 1,653 individuals who had confirmed COVID-19 and regularly logged their symptoms using the COVID Symptom Study app, which was developed by the King’s College London and ZOE. Their analysis classified six distinct types of COVID-19 distinguished by clusters of symptoms and used type to predict the need for respiratory support. Wise published a summary and interpretation of this study. https://doi.org/10.1136/bmj.m2911 Sudre et al. (June…
Neutralizing and Binding Antibody Kinetics of COVID-19 Patients during Hospital and Convalescent Phases
[pre-print, not peer-reviewed] Yao et al. analyzed antibody kinetics using 244 serial blood samples from 34 people with COVID-19. All types of antibodies measured were detected approximately two weeks after illness onset. Based on estimated half–life, the authors estimated median times to seronegativity following disease onset to be 4.6 months for IgM (IQR 4.1-5.0), 7.8 months for IgA (IQR 6.7-9.2), and 43 months (IQR 34-48) for IgG. Neutralizing antibodies (Nab) declined faster than IgG…
July 20, 2020
Recurrence of Positive SARS-CoV-2 Viral RNA in Recovered COVID-19 Patients during Medical Isolation Observation
Yuan et al. report that 11% of recovered COVID-19 patients were found to be SARS-CoV-2 RNA positive one or two weeks after hospital discharge, although none were symptomatic at the time of testing. Patients under 18 and patients with shorter hospital stays were more likely to have a positive re-test; no severe cases tested positive after discharge. …
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