May 19, 2020 - a podcast by COVID19LST

from 2020-05-21T02:23:03

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Your daily COVID-19 LST Report:


— Climate:  Based on a 2018 systematic review of the SARS and MERS literature, authors identified key areas of research for these coronaviruses. They noticed that research was lacking in viral pathogenesis, clinical characterization, infection prevention and candidate therapeutics, and therefore recommend prioritizing research in these fields for the study of SARS-CoV-2.


— Epidemiology:  Contact tracing in Korea linked initial COVID-19 cases to several fitness class instructors.  26% of participants in their classes developed infection. Investigators speculate that the environment of a fitness class: a moist, warm atmosphere in a confined area coupled with turbulent airflow generated by intense physical exercise can lead to a higher rate of transmission.


— Understanding the Pathology:  Iranian neuroscientists performed a literature review investigating the neuroinvasive potential of coronaviruses, and found four suggested routes of entry into the central nervous system (CNS): 1) Through olfactory neurons in the olfactory epithelium.

2) Via infected monocytes crossing the blood-brain barrier (BBB) to infect glial and neuronal cells.  3) Through interaction of CoV and ACE2 receptors on BBB endothelial cells.  4) Via Peripheral nerves (trans-synaptic transmission)


— Management:  Monitoring procalcitonin levels may help identify patients at risk of severe disease - a meta-analysis of 4 studies found that “increased procalcitonin values are associated with a nearly 5-fold higher risk of severe SARS-CoV-2 infection.”


— Guidelines:  A meta-analysis investigating outcomes in 51 patients who developed postoperative COVID-19 found a mortality rate of 27% suggesting the importance of preoperative testing of asymptomatic patients.


 — R&D:  Korean laboratory proposes guidelines for diagnosing COVID-19.


They recommend:



  • Test Indications: Testing is appropriate to confirm suspected cases of COVID-19 and make decisions on continuing or discontinuing quarantine.


  • Diagnostic Methods: RT PCR is recommended, but the authors call for more studies to identify the optimal target gene for these tests. Repeat testing may be necessary.


  • Specimen Selection: For asymptomatic individuals, a combination of nasopharyngeal and oropharyngeal swabs is recommended. For patients with severe systems, lower respiratory tract specifics (sputum, bronchoalveolar lavage, tracheal aspirates) are recommended.


  • Biosafety: These recommendations are presented in the full report.



— Visit COVID19LST.org for our full report with links to the articles.


— Reach out to us at: contact@covid19lst.org



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