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Topic: Testing and Treatment
June 5, 2020
Incidence of COVID-19 in Pediatric Surgical Patients Among 3 US Children’s Hospitals
Universal pre-operative screening for SARS-CoV-2 infection at the Children’s Hospital of Philadelphia, Texas Children’s Hospital, and Seattle Children’s Hospital from March 26-April 22, 2020 found that 0.93% of children were positive, ranging from 0.22% to 2.65% across these hospitals. Fifty percent of positive children had symptoms and 20% had known exposure. Increasing age and emergency status of procedure were positively associated…
Pre-Procedural Surveillance Testing for SARS-CoV-2 in an Asymptomatic Population in the Seattle Region Shows Low Rates of Positivity
Universal screening of patients prior to admission or a surgical or aerosol-generating procedure in the University of Washington hospital system was instituted on April 13, 2020. Since that time, 10% of patients with COVID-19 symptoms were SARS-CoV-2 positive compared to fewer than 1% of asymptomatic individuals. Mays et al. (June 3, 2020). Pre-Procedural Surveillance Testing for SARS-CoV-2 in an Asymptomatic Population in the Seattle Region…
June 4, 2020
Swabs Collected by Patients or Health Care Workers for SARS-CoV-2 Testing
Tu et al. evaluated the sensitivity of non-nasopharyngeal swabs self-collected by patients, compared to nasopharynx swabs collected by a health care worker, for the diagnosis of COVID-19. The estimated sensitivities of the tongue, nasal, and mid-turbinate self-collected samples were 89.8% (97.5%CI 78.2-100.0), 94.0% (83.8-100.0), and 96.2% (87.0-100.0), respectively. Tu et al. (June 3, 2020). Swabs Collected by Patients or Health Care Workers for SARS-CoV-2 Testing. The New…
Effect of Convalescent Plasma Therapy on Time to Clinical Improvement in Patients With Severe and Life-Threatening COVID-19: A Randomized Clinical Trial
Li et al. conducted a multicenter randomized trial of convalescent plasma therapy among 103 participants with “severe” or “life-threatening” COVID-19 in Wuhan, China. The trial was stopped early, which resulted in insufficient power to fully evaluate the primary outcomes. Overall, there were no statistically significant differences in clinical improvement within 28 days between those who did and did not receive convalescent plasma. However, an accompanying editorial points to promising trends among…
Retraction: “Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis”
Retraction: Authors of an article previously published in the Lancet regarding treatment of COVID-19 with hydroxychloroquine or chloroquine retracted the article after Surgisphere declined to make the primary data available for an independent third party review. Mehra, Ruschitzka & Patel. (June 4, 2020). Retraction: “Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis”. Lancet. https://doi.org/10.1016/S0140-6736(20)31324-6
June 3, 2020
Rapid Point of Care Nucleic Acid Testing for SARS-CoV-2 in Hospitalised Patients a Clinical Trial and Implementation Study
[pre-print, not peer reviewed] Collier et al. evaluated a point of care (POC) nucleic acid amplification test (NAAT) (called the SAMBA II) for SARS-CoV-2. The sensitivity and specificity of SAMBA II were 96.9% and 99.1%, respectively, and the median time to test result was 2.6 hours. The authors also compared hospital outcomes associated with implementation of…
Clearance and Persistence of SARS-CoV-2 RNA in COVID-19 Patients
Carmo et al. found that most patients continue to test positive for SARS-CoV-2 for over two weeks. The minimum time from first positive to first negative SARS-CoV-2 RT-PCR test result was 7 days, while some patients continued to test positive for 51 days following their first positive test result. Viral RNA persistence was not associated with severity of disease, but may be associated with…
Expression of Concern: Hydroxychloroquine or Chloroquine with or without a Macrolide for Treatment of COVID-19: A Multinational Registry Analysis
The Lancet and the New England Journal of Medicine have both issued Expressions of Concern about the validity of the data used for two articles regarding the use of hydroxychloroquine or chloroquine for the treatment of COVID-19 published by authors associated with a company called Surgisphere Corporation. These articles both utilized retrospective data from an international database that included electronic health records from 169 hospitals on three continents. Editors….
A Randomized Trial of Hydroxychloroquine as Postexposure Prophylaxis for Covid-19
A placebo-controlled randomized trial of hydroxychloroquine as post–exposure prophylaxis (PEP) for SARS-CoV-2 found no evidence of efficacy. Among 821 asymptomatic participants, 88% reported a high-risk exposure to a confirmed COVID-19 case. There was no difference in SARS-CoV-2 acquisition between participants receiving hydroxychloroquine (12%) and those receiving placebo (14%). No serious adverse reactions were reported, although side effects were more common with hydroxychloroquine than…
June 2, 2020
First Case of Drug‐induced Liver Injury Associated with the Use of Tocilizumab in a Patient with COVID‐19
[pre-print, not peer reviewed] Muhovic et al. present a case of probable drug-induced liver injury in a patient with severe COVID-19 who received tocilizumab. One day after receiving the drug, which functions as an inhibitor of interleukin-6, acute liver injury was verified in laboratory analyses. Biopsy to diagnose drug-induced liver injury was not performed due to the patient’s fragile condition. The authors suggest the need…
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