November 12, 2020 - a podcast by COVID19LST

In today's episode we discuss:

—Epidemiology: A retrospective cohort study by physicians in Wuhan, China found no significant difference in levels of testosterone, follicle-stimulating hormone, or luteinizing hormone between 39 male patients with SARS-CoV-2 and 22 control patients without SARS-CoV-2 (p<0.05) nor between cases with severe versus moderate disease severity; however, 20 patients with >50 days of viral shedding  had elevated estradiol levels compared to those with shorter shedding duration (p<0.05), suggesting that SARS-CoV-2 is unlikely to cause sterility or hypogonadism.

—Transmission & Prevention: An international group of vaccine development experts from the Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV) Working Group conducted a review of available literature regarding vaccine-associated enhanced disease and determined that the risk of COVID-19 VAED is similar to the risk associated with any other viral vaccine and acknowledge that the human experience of COVID-19 may differ from animal or in-vitro studies, recommending rigorous surveillance and phase 3 trials to evaluate safety and efficacy of any COVID-19 vaccine.

—Management: A retrospective cohort study by pediatricians in Florence, Italy of central precocious puberty (CPP) in girls presenting to their clinic during and after the Italian COVID-19 lockdown (March-July 2020) compared to the same period in 2015-2019 found more new cases of CPP in 2020 compared to previous years (37 vs. 16-19, p<0.0005) with accelerated progression in girls with previously diagnosed CPP (p<0.0005), more advanced Tanner stage in newly diagnosed CPP (p<0.005), and higher levels of luteinizing hormone (LH) and estradiol (E2) (p<0.005). These changes are attributed to the psychological stresses, increased BMI, and increased electronic device use during lockdown and suggest environmental factors strongly influence pubertal development.

—Adjusting Practice During COVID-19: A letter to the editor by The Netherlands Comprehensive Cancer Organization discusses derailed oncological care due to COVID-19 and subsequent reprioritization of health care services and determined that healthcare changes resulting from COVID-19 contributed to fewer breast and colorectal cancer diagnoses among age groups eligible for cancer screening, with slow return to expected rates following gradual restarts of cancer screenings. More information is needed to determine the long term clinical outcomes of decreased cancer screening and diagnoses, particularly whether these findings may represent decreased "overdiagnosis of particular early-stage cancers," but believe the trend warrants further investigation.

—R&D: Diagnosis & Treatments: Spanish immunologists investigated immunogenicity of cysteine-like protease (Mpro, a non-structural SARS-CoV-2 protein) by comparing samples from 36 COVID-19 patients diagnosed via RT-PCR versus 33 negative controls and, using ELISA (Mpro sensitivity 97% and specificity 100%), found high titers of IgG, IgM, and IgA against Mpro in serum and detected Mpro antibodies in all saliva samples collected from patients with the highest serum antibody titers, suggesting that detection of Mpro antibodies could be used to distinguish infected from non-infected individuals and that saliva tests could be used as a reliable, non-invasive test for seropositivity.

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