Weekly Review: What’s new in the COVID-19 clinical world? – February 22, 2021

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Weekly Review: What’s new in the COVID-19 clinical world? – February 22, 2021

Weekly Review: What’s new in the COVID-19 clinical world? – February 22, 2021

Sequelae in adults six months after COVID infection

In this article, authors discuss the persistence of symptoms reported in patients who have experienced coronavirus up to six months after infection. Of the 234 participants enrolled, 177 completed the survey. When diagnosed, 6.2% of participants were asymptomatic, 84.7% were outpatients with mild illness, and 9% had moderate or severe disease requiring hospitalization. The most common comorbidity among this group was hypertension. A follow up survey was sent among participants who report the following symptoms as persistent after overcoming the virus: fatigue (13.6%), loss of sense of smell or taste (13.6%), brain fog (2.3%). Among 51 outpatients and hospitalized patients, 30.7% reported worsened health-related quality of life when compared to baseline, and 7.9% reported negative impacts on at least one activity of daily living such as household chores. Some of the individuals were followed for up to 9 months after illness and continued to report persistence of symptoms. Consistent with existing literature, fatigue is the most commonly reported symptom to linger after infection with COVID-19. Study limitations include sample size, single study location, potential bias of self-reported symptoms, and loss to follow up. Comprehensive investigation over the long-term will be needed to fully understand the lasting effects of COVID-19 infection and the impact of this evolving viral pathogen.

Cardiovascular sequelae in uncomplicated COVID-19 survivors

In this article, authors discuss data pertaining to cardiac sequelae after surviving COVID-19. The study screened 97 COVID-19 survivors with ECG, echocardiography, serum troponin and NT-proBNP assay 1-4 weeks after hospitalization. Treadmill stress tests and cardiac MRI were also performed if indicated. The participants’ mean age was 46.5 ± 18.6 years, 53.6% were male. All were classified with non-severe disease without cardiac manifestations and did not require ICU care during infection. Cardiac abnormalities were detected in 42.3% of participants studied. These included sinus bradycardia (<50 bpm) in 29.9% of participants, newly detected T-wave abnormalities (8.2%), elevated troponin levels (6.2%), new onset atrial fibrillation (1.0%), and newly detected left ventricular systolic dysfunction with elevated NT-proBNP levels (1.0%). Sinus bradycardia appears to be self-limiting, and those with persistent troponin elevation, T wave abnormalities, etc. did not indicate evidence of infarct, myocarditis, or left ventricular systolic dysfunction. The article concludes that cardiac abnormalities may be common among those who survive COVID-19 with mild disease, most are self-limiting issues. Cardiac surveillance is recommended to detect more severe cardiac involvement including afib and left ventricular dysfunction.

Analysis of factors that cause false-negative RT-PCR testing

This cross-sectional study analyzed factors such as patient characteristics, sampling techniques, and COVID-19 manifestations that may cause false-negative RT-PCR testing in patients. Patients with positive RT-PCR tests in the first nasopharyngeal and oropharyngeal swabs were accepted as true positives, and patients with three negative, consecutive swabs results were considered true negative. Those who had an initial negative swab were considered to be “false negatives” if they tested positive on the 2nd or 3rd swab. Demographic data, disease onset, nasal septal deviation, epistaxis, clinician who collected the sample, and medical treatments which affect the laryngopharyngeal reflux, allergic rhinitis, etc. were documented. Dependent variable analysis was performed with the chi-square tests, with binary logistic regression used for significant variables. The study concluded that patients and/or sample-related factors can affect results among RT-PCR testing. The presence of these factors can be determined when there is high clinical suspicion and negative testing. The presence of ageusia, anosmia, early sampling (0.95 × 10^9/L. The article concluded that PLC had a nonlinear relationship with mortality risk in COVID-19 patients. Reduced PLC’s were associated with increased mortality risk in COVID-19 patients.

Effects of COVID-19 on musculoskeletal pathology

This article, discusses SARS-CoV-2 infection and extra-pulmonary manifestations including myalgias and musculoskeletal complications that have emerged during the pandemic. These reports include various reports of rheumatologic and neuromuscular conditions such as myositis, neuropathy, arthropathy, and soft tissue abnormalities. The authors intend to provide a first comprehensive summary of these manifestations and provide a wealthy review of imaging to accompany the article. Multimodality imaging is encouraged to assist in diagnosis and evaluation of COVID-19 related musculoskeletal pathologies.

|2021-02-22T08:11:46-05:00February 22nd, 2021|COVID-19 Literature|Comments Off on Weekly Review: What’s new in the COVID-19 clinical world? – February 22, 2021

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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