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Topic: Testing and Treatment
March 9, 2021
Performance of National COVID-19 ‘Symptom Checkers’: A Comparative Case Simulation Study
Using simulated patients designed to have signs and symptoms consistent with typical COVID-19 presentations as well as patients with conditions that can mimic COVID-19 (e.g. sepsis and bacterial pneumonia), the CDC Coronavirus Symptom Checker only successfully triaged 38% of cases to seek further health assessment. In contrast, the corresponding symptom checkers used in the UK,…
A Rapid Method to Evaluate Pre-Travel Testing Programs for COVID-19 A Study in Hawaii
[Pre-print, not peer-reviewed] A rapid field study conducted in the Kahului main airport in Maui, Hawaii identified 2 SARS-CoV-2 PCR positive participants out of 279 consecutively sampled participants boarding for departure, despite all participants having a negative PCR test 72 hours prior. This positivity rate corresponded to 7 cases per 1,000 travelers, which corresponds to…
March 8, 2021
Rapid Increase of SARS-CoV-2 Variant B.1.1.7 Detected in Sewage Samples from England between October 2020 and January 2021
[Pre-print, not peer-reviewed] Between October 2020 and January 2021, a rapid increase in the SARS-CoV-2 variant B.1.1.7 was detected in sewage samples in England. Viral RNA containing B.1.1.7 mutations was first identified in a sample collected in London on November 10 and detected in 7-9% of all sewage samples in November, increasing to >95% by January…
Impact of Remdesivir on 28 Day Mortality in Hospitalized Patients with COVID-19 February 2021 Meta-Analysis
[Pre-print, not peer-reviewed] A meta-analysis of peer-reviewed randomized controlled trials (n = 4 studies, 7,333 patients) did not find differences in survival between patients receiving remdesivir versus usual care or placebo (OR = 0.89, 95% CI 0.65-1.21). Considerable variability in illness severity was noted, with between 0-27% of patients mechanically ventilated at the time of…
Diagnosis of SARS-Cov-2 Infection by RT-PCR Using Specimens Other Than Naso- and Oropharyngeal Swabs: A Systematic Review and Meta-Analysis
A systematic review and meta-analysis of SARS-CoV-2 RT-PCR testing using samples other than naso- or oropharyngeal swabs found that saliva samples had the highest accuracy (92%), with a sensitivity of 84% and specificity of 96%. Deep throat saliva/posterior oropharyngeal saliva samples had an overall accuracy of 80%, with a sensitivity of 90% and specificity of…
March 5, 2021
Sarilumab in Patients Admitted to Hospital with Severe or Critical COVID-19: A Randomised, Double-Blind, Placebo-Controlled, Phase 3 Trial
In a randomized, placebo-controlled, double-blind trial, the IL-6 receptor inhibitor sarilumab did not reduce the median time to improvement by day 29 among patients hospitalized for COVID-19 compared to placebo (n=416). Patients receiving placebo had a median time to improvement of 12 days, compared to 10 days among those receiving either 200 mg or 400…
Tocilizumab plus Standard Care versus Standard Care in Patients in India with Moderate to Severe COVID-19-Associated Cytokine Release Syndrome (COVINTOC): An Open-Label, Multicentre, Randomised, Controlled, Phase 3 Trial
A multi-center, phase-3, randomized trial among patients (n=180) with moderate to severe COVID-19 conducted at 12 hospitals across India of the anti-IL-6 receptor monoclonal antibody treatment tocilizumab found no significant difference in the proportion of patients with progressive COVID-19 up to day 14 between the treatment group compared to standard care group (9% vs 13%)….
Articles Azithromycin for Community Treatment of Suspected COVID-19 in People at Increased Risk of an Adverse Clinical Course in the UK (PRINCIPLE): A Randomised, Controlled, Open-Label, Adaptive Platform Trial
Use of the antibiotic azithromycin plus usual care did not provide meaningful benefits to recovery time from COVID-19 compared to usual care alone, according to a randomized, placebo-controlled, open-label trial in the UK from May to November 2020. Patients receiving azithromycin plus usual care (n=500) had similar time to recovery compared to patients receiving usual…
March 4, 2021
Non-Steroidal Anti-Inflammatory Agent Use May Not Be Associated with Mortality of Coronavirus Disease 19
In a study of patients with COVID-19 using non-steroidal anti-inflammatory drugs (NSAIDs) or acetaminophen, there was no significant difference in all-cause mortality between the groups (4% vs 3%, HR=1.33, 95% CI: 0.63-2.88) after using propensity score matching to create comparable groups of treated and untreated patients (n=397 data pairs). There were also no significant differences…
Effect of Ivermectin on Time to Resolution of Symptoms Among Adults With Mild COVID-19
In a randomized clinical trial among patients with symptomatic, laboratory-confirmed SARS-CoV-2 infection (n=400), a 5-day course of ivermectin did not significantly improve the time to symptom resolution compared with placebo (10 vs 12 days, HR=1.07, 95%CI: 0.87-1.32). Fifteen (7.5%) patients in the ivermectin group versus 5 (2.5%) in the placebo group discontinued treatment due to…
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