Weekly Review: What’s new in the COVID-19 clinical world? – October 19, 2020

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Weekly Review: What’s new in the COVID-19 clinical world? – October 19, 2020

Weekly Review: What’s new in the COVID-19 clinical world? – October 19, 2020

Thromboprophylaxis treatment in critically ill COVID-19 patients

In this article, a patient-tailored thromboprophylaxis protocol is discussed to reduce rates of venous and arterial thrombotic events related to COVID-19 in critically ill patients. Approximately 20-60% of critically ill COVID-19 patients have experienced some type of thrombosis during their infectious period. The authors predicted that patients who received high-intensity thromboprophylaxis treatment would have fewer thrombotic events. The retrospective study aimed to explore the incidence of thrombotic events and evaluate the incidence of hemorrhagic events. A total of 188 patients met inclusion criteria for this study and 182 of them received some type of prophylaxis. Of these, 75 (40%) received high‐intensity thromboprophylaxis and 24 (12.8%) were treated with therapeutic anticoagulation. Twenty‐one patients (11.2%) experienced 23 thrombotic events (incidence rate of 12.2% (95%CI 7.9–17.8)), including 12 deep venous thromboses, 9 pulmonary emboli and 2 peripheral arterial thromboses. The multivariable logistic regression analysis showed that only D‐dimer (OR 2.80, p=0.002) and high‐intensity thromboprophylaxis regimen (OR 0.20, p=0.01) were independently associated with thrombotic eventsThe study concluded that a proactive approach to managing critically ill patients may prevent thrombotic events without increasing the risk of bleeding.

Demographics and clinical characteristics among patients with COVID-19 and pulmonary involvement

This study, discusses the range of symptoms associated with severe and critical patients who experience lower pulmonary involvement during the course of COVID-19 infection and aimed to describe baseline clinical characteristics of those who experience pulmonary involvement. By analyzing data from 3,471 US patients hospitalized with COVID-19 and pulmonary involvement, those from the South and Midwest were among the highest with pulmonary issues. The most common comorbidities were hypertension, diabetes, hyperlipidemia, and obesity. Racial disparities are also discussed.

Can quantitative Chest CT analysis provide reliable information when diagnosing COVID-19?

In this article, authors aim to evaluate the reliability of using Quantitative Chest CT when discriminating COVID-19 patients from non-Covid-19 patients. Patients were enrolled and divided into groups based on positive/negative RT-PCR results. The final study enrolled 190 patients and after thorough evaluation, it was determined that quantification of ground glass opacities and fibrotic changes on chest CT could be able to reliably determine patients with COVID-19.

Vertical transmission of COVID-19 during pregnancy

In this article, authors seek to determine the impact of COVID-19 on gestation. The authors analyzed the viral genome on maternal and newborn nasopharyngeal swabs, vaginal swabs, maternal and umbilical cord plasma, placental and umbilical cord biopsies, amniotic fluid and milk from 31 mothers who tested positive for COVID-19. The data from this study concludes that in-utero vertical transmission is low, however, it is possible. Further studies are recommended to ascertain long-term outcomes and potential intrauterine vertical transmission to determine risk during first and second trimesters.

Antibody seroconversion in asymptomatic and symptomatic patients with COVID-19

In this article, the authors aimed to characterize the clinical features and immune responses of those who are asymptomatic when compared to those who are symptomatic and infected with SARS-CoV-2. Of the 214 patients with positive results, 12% were asymptomatic during hospitalization. Among these patients, 96% were age 60 years or younger, female, and had few comorbidities. Serum levels of white and red blood cells were higher in those who were asymptomatic than in those who expressed symptoms. IgG seroconversion was commonly observed in both symptomatic and asymptomatic patients, and the median time from the first positive screening to IgG or IgM seroconversion was significantly shorter in asymptomatic than in symptomatic patients. In conclusion, asymptomatic patients and symptomatic patients exhibited different IgG and IgM responses to the SARS-CoV-2 virus. Asymptomatic patients may clearly transmit the virus which encourages early diagnosis and treatment.

|2020-10-19T09:56:09-04:00October 19th, 2020|COVID-19 Literature|Comments Off on Weekly Review: What’s new in the COVID-19 clinical world? – October 19, 2020

About the Author: Casey Cummins

Casey Cummins
Casey Cummins, MSN, APRN, NP-C is a board-certified Family Nurse Practitioner who currently serves as the Chief Nurse Consultant for the Immunizations Division at the Indiana Department of Health. She is part of the ISDH COVID-19 Outbreak Response Team, and has assisted with coordinating testing efforts state-wide during the pandemic. She enjoys spending time with her husband and their children, being outdoors, gardening, and traveling whenever possible.

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