July 28, 2020 - a podcast by COVID19LST

On today's episode we discuss:

— Climate: A cross-sectional study surveying 128 researchers, clinicians, and academic personnel showed that 63.3% found social media to be the most important source of information while 67.2% found it to be misinformation. A majority of the respondents supported mandatory peer review and organization of a trustworthy COVID-19 database to combat potentially deadly misinformation.

A systematic review and meta-analysis evaluating 14 qualifying studies claims to have found that COVID-19 patients with a BMI exceeding 25 kg/m^2 had worse prognosis in all age groups, especially the elderly population, suggesting that this population should be "given special attention to reduce morbidity and mortality associated with COVID-19 infection" to limit their moderate-to-high complication risk.

A survey study conducted in London, England by Imperial College London found among 167 St. Mary's Hospital healthcare workers, 44% attested to self-quarantining during the past 4 months due to symptoms consistent with COVID-19 and 54% of symptomatic workers tested RT-PCR positive. Since previous infection and positive antibody tests do not necessarily indicate immunity, this study suggests a possible massive shortage of healthcare workers during the anticipated second wave of COVID-19 in November 2020 and calls for the creation of safety guidelines in order to prevent such a shortage.

— Transmission and Prevention: A retrospective study of presumed COVID-19 negative patients (n=103) conducted at four inpatient rehabilitation facilities (IRF) in New Jersey, USA found 6.8% of asymptomatic participants (n=7) tested positive for SARS-CoV-2 on admission (71% [n=5] of this group developed symptoms in 2-5 days), and overall 11.6% (n=12) tested positive within 14 days of admission. Authors suggest SARS-CoV-2 testing on admission to post-acute care settings is worthwhile for appropriate infection control regardless of symptom presence.

— Management: A systematic review of 46 case series and case studies with radiologic findings from 923 symptomatic and asymptomatic pediatric patients diagnosed with COVID-19 by RT-PCR found that:

1. Chest CT was the most common imagining modality used

2. Chest CT was able to detect radiological evidence of COVID-19 in 19% of asymptomatic patients.

3. The most common abnormality seen on scans was ground-glass opacities (39%), and

4. The most common location of lesions was the lower lobe of the right lung (40%).

These findings emphasize the need for further investigation of chest CT as a screening tool for COVID-19 in children and for study of other imaging alternatives like lung ultrasound to minimize exposure to radiation.

A case report conducted at the Department of Internal Medicine at Michigan State University highlights the case of a 29-year-old male who died from COVID-19 acute respiratory distress syndrome (CARDS) and ventilator-induced lung injury (VILI), displaying both phenotypes of CARDS, the milder type L form and the more severe type H form (which resembles full-blown ARDS). The patient's cause of death was a tension pneumothorax from VILI associated with type H CARDS. This case suggests the need for a better understanding of CARDS and transition to type H in order to prevent patients' entry to the VILI vortex and potential death from COVID-19.

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