Result for
Topic: Testing and Treatment
July 24, 2020
Spatial and Temporal Dynamics of SARS-CoV-2 in COVID-19 Patients: A Systematic Review and Meta-Analysis
A systematic literature review (37 studies, 22 used in meta-analysis) showed consistent recovery of SARS-CoV-2 genetic material from the upper respiratory tract (URT), the lower respiratory tract (LRT), and the feces, regardless of clinical severity. SARS-CoV-2 was found to persist for longer in moderate-to-severe patients versus mild patients for both the URT and feces, and to persist…
Initial Experience in Predicting the Risk of Hospitalization of 496 Outpatients with COVID-19 Using a Telemedicine Risk Assessment Tool
[pre-print, not peer-reviewed] O’Keefe et al. describe the use of a risk assessment tool for telemedicine assessment of outpatients diagnosed with COVID-19. Out of 496 patients with COVID-19 confirmed by self-testing, increasing risk tier was positively associated with risk of hospitalization (Tier 2 vs Tier 1: HR=3.74; Tier 3 vs Tier 1: HR=10.87) (adjusted for age,…
Convalescent Plasma Treatment for SARS-CoV-2 Infection: Analysis of the First 436 Donors in England, 22 April to 12 May 2020
Among 436 convalescent plasma donations collected from individuals with confirmed (59%) or suspected (41%) SARS-CoV-2 infection by the UK National Health Service at least 30 days after diagnosis, 87% were positive for IgG antibodies and 76% were positive for neutralizing antibodies. Among those with confirmed SARS-CoV-2, 99% had IgG antibodies and 88% had neutralizing antibodies. Neutralizing antibody titers were high enough to be used for treatment of other SARS-CoV-2 patients in 34%…
July 23, 2020
Historically Controlled Comparison of Glucocorticoids with or without Tocilizumab versus Supportive Care Only in Patients with COVID-19-Associated Cytokine Storm Syndrome: Results of the CHIC Study
Ramiro et al. evaluated clinical records of 86 patients with severe COVID-19-associated cytokine storm syndrome who received an intensive course of glucocorticoids. Compared to an untreated historical group of patients who received supportive care only (1:1 match on sex and age), treated patients had a higher rate of reaching respiratory recovery (HR=1.8), were less likely to die (HR=0.35), and had a lower rate of invasive mechanical ventilation (HR=0.29). Ramiro et al….
Chloroquine Does Not Inhibit Infection of Human Lung Cells with SARS-CoV-2
TMPRSS2 is a cellular protease gene that activates SARS-CoV-2 for entry into lung cells. Hoffmann et al. report that the engineered expression of TMPRSS2 in ex-vivo Vero cells renders SARS-CoV-2 infection insensitive to chloroquine. Moreover, chloroquine did not block SARS-CoV-2 infection in TMPRSS2-positive lung cells. The authors conclude results indicate that chloroquine targets a pathway for viral activation that is not operative in lung cells and is unlikely to protect against…
Saliva as a Diagnostic Specimen for Detection of SARS-CoV-2 in Suspected Patients: A Scoping Review
A review of 9 studies (293 total samples) found no statistically significant difference in viral loads between saliva, nasopharyngeal, or sputum specimens obtained for the detection of SARS-CoV-2. The authors suggest that these findings indicate that self-collected saliva may be a reliable and non-invasive approach for the detection of SARS-CoV-2 using RT-PCR. Fakheran et al. (July 15, 2020). Saliva as a Diagnostic Specimen for Detection of SARS-CoV-2 in Suspected Patients: A Scoping Review. Infectious Diseases of Poverty. https://doi.org/10.1186/s40249-020-00728-w
Comparison of Unsupervised Home Self-Collected Midnasal Swabs With Clinician-Collected Nasopharyngeal Swabs for Detection of SARS-CoV-2 Infection
Compared to clinician-collected swabs, home-based self-collected swabs had a sensitivity of 80.0% (95% CI: 63–91%) and a specificity of 97.9% (95% CI: 94–99.5%). These results were based on a cohort of 185 symptomatic people who presented at drive-through clinics in Washington State who underwent both an unsupervised home self-collected swab and a clinician-collected nasopharyngeal swabs for diagnosis of SARS-CoV-2 infection by RT-PCR. McCulloch et al. (July 22, 2020). Comparison of Unsupervised Home Self-Collected Midnasal Swabs With Clinician-Collected Nasopharyngeal Swabs…
July 22, 2020
Clinical Efficacy of Convalescent Plasma for Treatment of COVID-19 Infections: Results of a Multicenter Clinical Study
A prospective cohort study (n=189) of COVID-19 patient in Iran showed that compared to the control group, participants receiving convalescent plasma therapy (n=115) had a significantly higher proportion of hospital discharge (98% vs 79%), shorter mean length of hospitalization (9.5 days vs 12.9 days), and lower proportion requiring intubation (7% vs 20%). Abolghasemi et al. (July 6, 2020)….
July 21, 2020
Experience with Tocilizumab in Severe COVID-19 Pneumonia after 80 Days of Follow-up: A Retrospective Cohort Study
Among 236 patients with severe COVID-19 pneumonia treated with tocilizumab over a median follow-up of 83 days, 55% required ICU admission, 49% required invasive mechanical ventilation, and 13% died. The investigators evaluated response to tocilizumab using multiple methods and found that the response defined by stable or decreasing scores on the Lower Brescia COVID Respiratory Severity Scale was associated with lower odds of mortality (OR=0.14, 95%…
July 20, 2020
Dexamethasone in Hospitalized Patients with Covid-19 — Preliminary Report
In the open-label RECOVERY trial among hospitalized COVID-19 patients, Horby et al. found that 28-day mortality was lower for patients receiving the steroid dexamethasone than for the usual care group among patients receiving invasive mechanical ventilation (29% vs. 41%) or supplemental oxygen without invasive mechanical ventilation (23% vs. 26%), but not among those who were receiving no respiratory support at randomization (18% vs. 14%). [EDITORIAL NOTE: A version of these findings was published as…
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