Clinical characteristics and lab results to predict severity of infection
In this retrospective study, authors attempt to identify early clinical and laboratory factors that may predict severe COVID-19 infection. Two cohorts were designed among 198 patients to designate those with a favorable evolution (the FE group) of infection, and those with an unfavorable evolution (the UFE group). Among those studied, older males with comorbidities and dyspnea at admission had significantly worse prognosis factors. The labs which supported this prediction were decreased lymphocyte and platelet counts and significantly lower glomerular filtration rates, while neutrophil to lymphocyte ratios, inflammation biomarkers, creatinine, aspartate aminotransferase, LDH, glycemia, and d-dimer rates were significantly higher. Procalcitonin and LDH were among the most accurate variables according to characteristic curves. The results of this study indicate that clinical and laboratory features may be able to predict high risk of ICU admission or even death during the time of admission. The authors encourage clinicians to use this study as a tool for triaging patients during the pandemic.
Public knowledge of COVID-19, trust in information sources, and adherence to social distancing
In this interesting cross-sectional survey, the authors discuss behavioral interventions and policies that have been implemented to reduce the spread of COVID-19. Although we currently have no vaccine or approved treatment, non-pharmacologic measures are being used to reduce the impact to the public during the pandemic. This study aimed to investigate associations between public knowledge about COVID-19, adherence to social distancing, and public trust in various sources, (i.e., governmental, private, and social networks). A survey of 1243 individuals determined that government information sources were most trusted, however, there were variations in trust by age and gender. White and older populations reported having the greatest trust in governmental sources such as the CDC, while non-white and younger groups expressed higher trust in private sources (CNN) and social media (Twitter). Trust in governmental sources was positively associated with accurate knowledge about the virus and adherence to social distancing. However, trust in private sources and social networks was negatively associated with knowledge and adherence. The authors urge policy makers to consider the quality of information that is disseminated through private and social networks and ensure that diverse populations have access to timely critical knowledge.
Hydroxychloroquine dosing based on patient characteristics
In this study, the authors discuss a variety of dosing schemes to support the use of hydroxychloroquine (HCQ) for the treatment of COVID-19. The authors performed an extended literature survey to investigate pharmacokinetics, efficacy, and safety of HCQ in treatment, and reviewed models to perform simulations to test their theory. The authors evaluated dosing schemes based on weight and levels of HCQ clearance impairment. Model simulations reviewed that high loading doses followed by lower, more sparse dosing offered significant benefits to patients. It has been shown that mortality, disease severity, and immune response are related to the viral load of the individual. By decreasing the viral load without reaching levels that cause adverse effects, the study provides evidence that adequate and proper HCQ dosing could provide benefits to COVID-19 patients.
Aerosolized transmission risk: Surgical or N-95 masks?
In this retrospective observational study, the authors describe the results of RT-PCR in healthcare workers who wore different types of personal protective equipment (PPE) who also had confirmed contact with a COVID-19 patients during procedures which caused particles to be airborne. In aerosolized procedures, it is noted that airborne particles can remain in the air for long periods and spread over distances further than 1 meter. The WHO recommends N95 respirators for any healthcare worker who manages patients when aerosolized generating procedures are performed. For this study, all healthcare workers were quarantined for 14 days after an exposure with a COVID positive patient. RT-PCR swabs were performed at different intervals. This accepted manuscript describes the clinical outcomes of healthcare workers who were exposed to SARS-COV-2 before the patient was knowingly diagnosed. One concern noted is inappropriate fit testing of N-95 respirators among healthcare workers. However. one study noted no difference in respiratory infection risk among groups who were properly fit tested and those who were not. The study concluded that many healthcare workers were compliant with N-95’s during intubation and ventilation procedures, but many used only surgical masks during nebulized treatments and oral suctioning. Among those studied, all tested negative on RT-PCR on days 1, 9, 13, and 15 after exposure. The link to the full article can be found here.
Using loss of smell and taste to diagnose COVID-19
In this systematic review, authors perform a comprehensive search of reliable studies to determine the diagnostic value of anosmia and dysgeusia during COVID-19 infection. Olfactory and taste dysfunction (OTD) were commonly reported among COVID positive patients, but there is no direct correlation between these symptoms and severity of infection. However, some patients reported a longer duration of these symptoms and increased severity when reported among young patients. The study concludes that the symptoms of OTD may be useful when screening for COVID-19, but should not be used independently to diagnose the condition.
Do eyeglasses reduce susceptibility to COVID-19?
In this article, the authors examined a cohort of 276 patients hospitalized with COVID-19 in Suizhou, China. For this study, the proportion of daily eyeglass wearers was lower than that of the local population (5.8% vs 31.5%). The study included those individuals who wore eyeglasses for more than 8 hours per day. The results indicate that those who wear eyeglasses daily were less susceptible to contracting COVID-19. It has been proven that COVID-19 spreads through droplets and contact, with the eye being an important route of infection. The study had a few limitations, such as being a single-center study with a small sample size. The results of this study support the use of eye protection, frequent hand washing, and not touching ones eyes to reduce infection with COVID-19.