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Topic: Testing and Treatment
October 22, 2020
The Use of Intravenous Immunoglobulin Gamma for the Treatment of Severe Coronavirus Disease 2019: A Randomized Placebo-Controlled Double-Blind Clinical Trial
Results from a randomized placebo-controlled trial in Iran (n=59) suggest that administration of intravenous immunoglobin (IVIG) could reduce in-hospital mortality rates due to severe COVID-19. Mortality was 20% in the IVIG group (6 of 30) vs 48.3% (14 of 29) in the placebo group. Multivariate analysis showed that IVIG was associated with a reduced in-hospital…
October 21, 2020
Characteristics and Outcomes of Clinically Diagnosed RT-PCR Swab Negative COVID-19 a Retrospective Cohort Study
[Pre-print, not peer-reviewed] Among 456 patients with clinical suspicion of COVID-19 and an initial negative PCR result for SARS-COV-2 by nasopharyngeal swab (March 1 to April 12, 2020), 94 (20%) were later confirmed as clinical COVID-19 cases. Among these, 47 (50%) tested positive with repeat PCR testing and 41 (44%) continued to have negative PCR…
Multiplex Rt-Real Time PCR Assays for Diagnostic Testing of SARS-CoV-2 and Seasonal Influenza Viruses
A multiplex RT-PCR assay was able to detect and discriminate between samples that were positive for SARS-CoV-2 and influenza and was able to detect co-infections. The authors suggest that the assay may be used for diagnostic and surveillance purposes during the seasonal influenza activity period. Mancini et al. (Oct 20, 2020). Multiplex Rt-Real Time PCR…
Quantitative Assessment of Olfactory Dysfunction Accurately Detects Asymptomatic COVID-19 Carriers
A novel design of an olfactory-action meter, which measures how well a person smells odors, found that 82% of asymptomatic SARS-CoV-2 carriers (n=34) had olfactory deficits, compared to 13% of health volunteers. By comparison, only 15% of asymptomatic carriers had olfactory deficits detected by subjective evaluation. This method evaluated a combination of olfactory detection abilities…
The Effect of Prior ACEI/ARB Treatment on COVID-19 Susceptibility and Outcome: A Systematic Review and Meta-Analysis
A systematic review and meta-analysis (49 studies) reported no association between treatment with angiotensin-converting enzyme inhibitors (ACEI) and/or angiotensin receptor blockers (ARB) and risk of SARS-CoV-2 infection (adjusted OR=1.00, 95%CI 0.94-1.05). The use of ACEI/ARB was also not associated with the risk of mortality (aOR=0.87, 95%CI 0.66-1.04) and severe outcomes (aOR=0.95, 95%CI 0.73-1.24). These findings…
October 20, 2020
Pooling of Samples to Optimize SARS-CoV-2 Diagnosis by RT-QPCR: Comparative Analysis of Two Protocols
Pooling naso- or oropharyngeal swab samples prior to RNA extraction was associated with 100% diagnostic accuracy, while pooling after individual-sample RNA extraction was associated with 91% diagnostic accuracy. Volpato et al. conclude that testing protocols should call for pooling swab samples before RNA extraction. Volpato et al. (Oct 16, 2020). Pooling of Samples to Optimize…
Tocilizumab for Treating COVID-19: A Systemic Review and Meta-Analysis of Retrospective Studies
A systematic review of case-control (n=2,285 patients) and single-arm studies (n=208 patients) found that treatment with the immunomodulator tocilizumab (TCZ) in COVID-19 patients was associated with a lower risk of admission to ICU, invasive ventilation, and mortality compared with standard treatment. Patients who received TCZ had changes of several clinical indicators that marked higher rates…
Effect of Tocilizumab vs Standard Care on Clinical Worsening in Patients Hospitalized With COVID-19 Pneumonia: A Randomized Clinical Trial
A randomized open-label trial of treatment with the immune modulator tocilizumab (TCZ) in patients with COVID-19 pneumonia found that the rate of clinical worsening (entry to ICU unit with intubation, death from all causes, or clinical aggravation) was not significantly different among patients receiving tocilizumab (TCZ) (n=60) and those receiving standard of care (n=66) (RR=1.05;…
Effect of Tocilizumab vs Usual Care in Adults Hospitalized With COVID-19 and Moderate or Severe Pneumonia
A randomized, open-label trial of patients with COVID-19 and pneumonia who required oxygen support but were not admitted to ICU found no statistically significant difference in mortality over 28 days between those receiving the immunomodulator tocilizumab (TCZ) (n=63) and those receiving standard of care (n=67). At day 14, the proportion of patients with noninvasive ventilation,…
October 19, 2020
Association of Time to Diagnosis with Socioeconomic Position and Geographical Accessibility to Healthcare among Symptomatic COVID-19 Patients: A Retrospective Study in Hong Kong
Living in public rental houses and living in an area with low educational attainment were associated with longer time to diagnosis in the first wave of SARS-CoV-2 infections in Hong Kong. In contrast, this association was not observed during the second wave of infections, when the surveillance measures were enhanced. The study examined socioeconomic characteristics…
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