November 3, 2020 - a podcast by COVID19LST

from 2020-11-08T23:30:52

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In today's episode we discuss:


—Climate: Hospital Volumes during the COVID-19 Pandemic in 2 US Medical Centers, Stanford University Medical Center and New York-Presbyterian/Weill Cornell Medical Center,  were explored with the incidence of 5 medical emergencies: acute MI, ischemic stroke, nontraumatic subarachnoid hemorrhage, ectopic pregnancy, and appendicitis. Authors found decreased incidence of acute myocardial infarction, non-traumatic subarachnoid hemorrhage, and ischemic stroke cases in both centers, a decrease in appendicitis cases in New York, and no changes in ectopic pregnancy cases at either center. They implicate that deferring seeking care for acute conditions due to the fear of contracting COVID-19 could be leading to the higher rates of at-home death of patients during the pandemic.


—Transmission & Prevention: Operation Warp Speed's Strategy and Approach are outlined by an affiliated physician scientist. It is a partnership of the Department of Health and Human Services, Department of Defense, and the private sector. Their goal is to advance “development, manufacturing, and distribution of vaccines, therapeutics, and diagnostics” to establish control over the COVID-19 pandemic. The initiative set objectives of delivering ~300 million doses of the SARS-COV-2 vaccine by mid-2021 with strict criteria by which companies have to comply in order to be accepted. Currently there are “eight vaccines in [their] portfolio which include “Moderna and Pfizer/BioNTech (both mRNA), AstraZeneca and Janssen (both replication-defective live-vector), and Novavax and Sanofi/GSK (both recombinant-subunit-adjuvanted protein).


Management: Among 89 COVID -19 ICU Patients at Newark Beth Israel Medical Center one study found 8.9% (n=8) developed nosocomial candidemia over an average ICU stay of 25 days. Compared to the control, they found that COVID-19 ICU patients with higher BMI, prolonged mechanical ventilation, and superimposed bacterial infections were associated with concomitant candidemia, but in-hospital mortality was not significantly changed. Authors suggest that providers be aware of systemic fungal infections as a potential complication in COVID-19 ICU patients.    


—R&D: Diagnosis & Treatments: The efficacy and safety of SARS-CoV-2 Neutralizing Antibody LY-CoV555, an antispike neutralizing monoclonal antibody,  were analyzed in a randomized, double-blind, controlled trial. The investigators examined the antibody's effect on viral load, symptom scores, and clinical outcome of 452 patients across 41 centers in the United States receiving one of three doses (700 mg, 2800 mg, or 7000 mg) or a placebo. Although the authors acknowledge the need for further studies, the trial so far indicates possible reduction in symptom severity and a reduction in viral load with higher doses of LY-CoV555, suggesting that LY-CoV555 could become a useful treatment for patients with a recent diagnosis of COVID-19.    


—Mental Health & Resilience Needs: Risk and Protective Factors for Prospective Changes in Adolescent Mental Health during the COVID-19 Pandemic were examined in a survey of 248 adolescents in the urban areas of New South Wales, Australia.



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