July 16, 2020 - a podcast by COVID19LST

On today's episode we discuss:

— Climate: A review of health-related workplace absenteeism in the United States during the pandemic found that workplace absenteeism during the pandemic had only increased in certain occupational subgroups: personal care service, healthcare support, and food processing. The authors postulate that this is due to the close interpersonal contact experienced in these occupations which creates a higher risk of COVID-19 transmission.

— Epidemiology:  A case report describes an 11-year-old boy who presented with symptoms of Guillain-Barre Syndrome three weeks after COVID-19 infection. The authors discuss that Guillain-Barre is a rare but documented phenomenon in adult COVID-19 patients but believe this to be one of the first descriptions of the condition in a pediatric patient.

— Understanding the Pathology:  A study of lab values in COVID-19 positive patients admitted to the ICU at Tongji hospital, Wuhan observed 12 thrombotic events in 9 patients with coagulation abnormalities which included lower natural anticoagulants, elevated Factor VIII, and presence of anti-phospholipid antibodies. In near-terminal patients, Factors V and VII were lower and prothrombin time was prolonged. These results suggest elevated Factor VIII and presence of anti-phospholipid antibodies may be involved in the etiopathology of COVID-19 hypercoagulable status, while lower Factor V and VII and prolonged PT may indicate advancing illness.

— Management:  A systematic review and meta-analysis of 22 observational cohort studies on renal complications in COVID-19 found that acute kidney injury was the most widely reported renal complication followed by need for renal replacement therapy, electrolyte disturbances, and acidosis. Meta-regression found a significant association between preexisting chronic kidney disease and COVID-19 associated acute kidney injury suggesting increased risk in these patients.

— R&D Diagnosis and Treatment:  American pathologists developed and evaluated immunohistochemical and in situ hybridization assays for tissue identification of SARS-CoV-2. They validated their methods through staining of COVID-19 autopsy samples including 8 lungs, 1 placenta, and 10 kidneys finding their protocols to be sensitive and specific for the virus. They provide protocols and reagent lists so that other pathology labs could easily replicate these techniques to study SARS-CoV-2 distribution across tissue types, allowing for a better understanding of tissue-specific pathogenesis.

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