June 1, 2020 - a podcast by COVID19LST

Your daily COVID-19 LST Report:

— Climate:  A research letter published in JAMA that analyzed pharmacy records during the pandemic, found a 1,977% increase in fills for Hydroxychloroquine/Chloroquine.  The authors warn that this sharp increase in demand may lead to medication shortages for patients who require these for treatment for their chronic conditions, such a s Systemic Lupus Erythematosus and Rheumatoid Arthritis.

— Epidemiology:  In pediatrics, a case series conducted at the Children’s Hospital of Philadelphia found evidence to support Multisystem Inflammatory Syndrome in Children (MIS-C) in six patients with COVID-19.  They report two notable findings associated with the condition include the development of neurological symptoms and hyponatremia. They note MIS-C resembles Kawasaki disease in clinical features and response to therapeutics, emphasizing the need for further research to determine if MIS-C is distinct clinical syndrome or an atypical presentation of Kawasaki disease.

— Understanding the Pathology:  Molecular docking analysis found an increased affinity (–8.6 kcal/mol) between dithymoquinone (an active ingredient in black seed) and the SARS-CoV-2 S protein: human ACE2 receptor interface. This binding could disrupt host recognition and the S-protein pathway for disease progression, suggesting dithymoquinone as a potential natural antiviral worth further studying.

— Management:  Clinicians at New York Presbyterian Hospital describe their protocol to place non-intubated, awake, mobile, and hemodynamically stable COVID-19 patients in the prone position in order to prevent worsening respiratory failure.

—R&D:  A prospective cohort study of 1788 patients in an Australian screening clinic found that the presence of either anosmia or ageusia exhibited a positive predictive value (PPV) for COVID-19 positivity of only 9.3%, suggesting that while these are more common in COVID-19 positive patients than negative (39.3% vs 8.9%, p<0.001), these should not be used as a screening tool for COVID-19.

— Mental Health and Resilience:  Social scientists in the United Kingdom suggest that social representations of COVID-19, such as social distancing and mask wearing, will be resisted as they lead to identity threats (loss of routine, interpersonal relationship changes, disconnection), indicating the importance of adaptive ways to address this threat.

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