June 29, 2020 - a podcast by COVID19LST

On today's episode we discuss:

—Climate:  A cross-sectional study of 640 adults found that COVID-19-related conspiracy theory (CT) beliefs correlated with pre-existing CT beliefs, lower education levels, and a negative perception of government responses. However, there was no correlation between CT beliefs and emotional stress during the pandemic.

—Epidemiology:  A multicenter retrospective cohort study from Wuhan comparing pediatric and adult COVID-19 patients found children were more likely to be asymptomatic, have lymphocytosis (vs lymphopenia in adults) and were less likely to respond to anti-viral treatments.

—Management: A prospective clinical study from the University of Utah suggest that SARS-CoV-2 infection induces activating changes in the transcriptome and proteome of platelets, possibly contributing to the immunothrombosis observed in COVID-19 disease.

—Diagnosis and Treatment:  Canadian authors describe policies implemented to reduce spread of infection in a 182-bed psychiatric facility, concluding that rapid identification of cases, aggressive testing for carriers, and swift movement of patients to isolation units are necessary to reduce nosocomial spread of COVID-19.

— Management:  Spanish authors describe pulmonary parameters in COVID-19 patients with acute respiratory distress syndrome (ARDS), finding a lack of association between PaO2/FiO2 and static compliance of the respiratory system, and a significant increase in oxygenation with prone position. They propose the underlying hypoxemia in COVID-19 ARDS results from dysfunction in lung perfusion.

— Adjusting Practice:  The authors argue that the emergency department is an unideal setting for making medical decisions regarding geriatric patients during the COVID-19 pandemic due to the paucity of critical information and the necessity for quick decisions. The authors suggest implementing diverse triage teams with administrative leadership, informing providers with regards to advanced directives, and delaying intubation until better decision-making can be made to improve patient outcomes and promote patient autonomy and beneficence.

—R&D Diagnosis and Treatment:  A meta-analysis of chest CT features in 2,451 COVID-19 pneumonia patients found that vascular enlargement, ground glass opacities, interlobar septal thickening, and subpleural bands are the most common findings.

-An in vivo drug trial of Remdesivir in a rhesus macaque animal model found reduced pulmonary findings on chest radiographs, reduced viral titers on bronchoalveolar lavage (BAL), and reduced lung damage on pathology, suggesting early initiation of Remdesivir may provide clinical benefit in severe COVID-19 respiratory disease.

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