August 5, 2020 - a podcast by COVID19LST

Epidemiology

· Investigators at the CDC performed an analysis of COVID-19 cases from early in the pandemic and found that among the first case reported in each of 99 countries, 60% were in individuals with a history of travel to China, Italy, or Iran.

Understanding the Pathology

· A retrospective study conducted in Spain found that a cohort of 134 COVID-19 patients had significantly elevated levels of uroporphyrin I, coproporphyrin I, and coproporphyrin III when compared to patients with COVID-19 negative pneumonia. These findings provide evidence to suggest that the accumulation of these markers may exacerbate heme shortages while also promoting oxidative damage and mitochondrial dysfunction in patients with COVID-19.

Transmission and Prevention

· A literature review by authors at John Hopkins and the University of California argues that wearing masks reduces disease severity by reducing the viral inoculum exposure of the wearer. The authors cite several countries, including South Korea, Singapore, Hong Kong, Taiwan, Japan, that have practiced population-level mask wearing and have low case fatality rates, suggesting the dual benefit of mask-wearing in allowing generation of herd immunity while preventing severe disease.

Management

· Investigators used data from 17 COVID-19 patients to assess differences in pulse oximetry (SpO2) and arterial oxygen saturation (SaO2) levels and found that SpO2 underestimated the SaO2 value by an average of 5.3%, which could cause overestimation of hypoxia in COVID-19 patients and administration of a higher inspired oxygen fraction than necessary.

Adjusting Practice during COVID-19

· A group of otolaryngologists reviewed 15 international recommendations to compile guidelines for sinus and anterior skull base surgery during the pandemic which include postponing elective surgeries, postoperative COVID-19 testing, and designating COVID-19 operating rooms.

R&D: Diagnosis and Treatments

· Researchers in Germany developed a novel in-cell enzyme-linked immunosorbent assay (ELISA) that can effectively quantify de novo synthesis of SARS-CoV-2 spike protein in fixed and permeabilized cells to offer a rapid and quantifiable detection method of the virus for use in future research.

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