August 10, 2020 - a podcast by COVID19LST

Epidemiology

· A case report of a 29-year-old SARS-CoV-2 positive woman with minimal, mild symptoms who underwent an uncomplicated and successful vaginal delivery revealed the following in the placenta:  1. Evidence of general placental vascular malperfusion possibly due to hypertrophic arteriolopathy; notably, there were no signs of fetal malperfusion or micro-thrombi and   2. Presence of SARS-CoV-2 in chorionic villi endothelial cells.   The authors posit that this case is the first report of placental SARS-CoV-2 in the setting of mild COVID-19 disease, where the patient had only symptoms of mild myalgias.

· In comparing hematological features in COVID-19 positive (n=30) and negative (n=40) children presenting to the emergency department in City Hospital Ankara, Turkey with symptoms of fever, cough, rhinorrhea, and sore throat, COVID-19 positive patients demonstrated neutrophils with lobulation abnormalities, vacuolated monocytes and lowered neutrophil and leukocyte counts (p=0.02). The lack of thrombocytopenia in children with COVID-19 may be responsible for the improved outcomes observed in children.

Understanding the Pathology

· Findings from an in-vitro study by authors affiliated with the University of Hong Kong and Hainan Medical University investigating the viral protein expression, replication kinetics, and host response in monocyte-derived dendritic cells (moDCs) and monocyte-derived macrophages (MDMs) upon infection by SARS-CoV-2 suggest that SARS-CoV-2-infected moDCs and MDMs in the lungs of COVID-19 patients may be a source of pro-inflammatory cytokine production, exacerbating the COVID-19 manifestation.

R&D: Diagnosis & Treatments

· A prospective study conducted at a Malaysian COVID-19 quarantine center of 217 asymptomatic adult males, where 160 tested positive, found a far greater SARS-CoV-2 detection rate using morning salivary samples (93.1%) when compared to nasopharyngeal swabs (52.5%) (p<0.001, 45.6% concordance, 47.5% discordance), suggesting that the higher accuracy of salivary analysis could play a role in improved diagnostics, decreasing direct healthcare worker-patient interaction and risk of transmission, improving transport preservation, reducing test wait time, and allowing for self-collection.

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