June 22, 2020 - a podcast by COVID19LST

On today's episode we discuss:

—Climate: An analysis of the economic impact of COVID-19 on older adults highlights that more than 1/3 of adults 65 years or older live in counties with a high cost of living and increased COVID-19 prevalence demonstrating an overlap between "infection rates and economic insecurities" during COVID-19 with nearly 25% of these adults relying on Social Security benefits that may be insufficient to meet financial needs during a pandemic. The authors encourage employment and economic recovery strategies to take into consideration the older population

—Epidemiology: A two-center retrospective study at Wuhan Pulmonary Hospital and Tongji Hospital examining 1,018 COVID-19 patients found that increased interleukin-6 (IL-6) levels (>20 pg/mL; P<0.001) and decreased CD8+ T cell levels (<165 cells/mul; P<0.001) are both independently associated with increased mortality in patients with COVID-19, suggesting that both of these indicators may help clinicians in prognostication and clinical decision making.

—Management:  A case series of 63 positive end-expiratory pressure (PEEP) titrations performed in 15 patients with COVID-19-related ARDS using electrical impedance tomography (EIT) found that high PEEP were from personalized PEEP at the level of lowest relative alveolar overdistention and collapse, PEEP set was positively correlated to BMI (p< 0.001), and individualized PEEP titration could result in improved clinical outcomes but further research is needed to confirm whether this personalized PEEP titration approach is safe and effective.

—Diagnosis and Treatment: A retrospective cohort conducted at Daegu Catholic University School of Medicine in Korea found that 31 COVID-19-positive patients treated with lopinavir-ritonavir had significantly shorter times to negative conversion of viral RNA than 34 COVID-19-positive patients treated with hydroxychloroquine (median, 21 days vs. 28 days; Figure 2); however, time until clinical improvement was not found to be different between these groups.

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