September 9, 2020 - a podcast by COVID19LST

On today's episode we discuss:

—Epidemiology:  Public health experts affiliated with Indiana University estimated the infection fatality ratios (IFR) of SARS-CoV2 based on antibody tests in a random sample of residents aged 12+ in Indiana. The average age of decedents was 76.9 (SD 13.1). 1099 COVID-19 deaths were recorded and the average IFR was 0.26%, but stratified IFR varied by age: >60yo IFR 1.71%, <40yo IFR 0.01%; and by race: whites IFR 0.18% and non-whites IFR 0.59%. These results from the SARS-CoV-2 population prevalence data suggest that risk of death increases with age and varies by race.

· A retrospective single center study (Hospital of the University of Paris, France) of 100 adult patients with confirmed SARS-CoV-2 admitted to the ICU, 81/100 of whom had mortality-associated varying severity of acute kidney injury (AKI), found no statistically significant association between complement activation/inflammatory markers (C3, IL-6, ferritin) and AKI as defined by urinary output and the Kidney Disease Improving Global Outcomes (KDIGO) criteria after adjusting for confounders.

—Understanding the Pathology: Cardiologists at Johns Hopkins University School of Medicine and Harvard Medical School discuss how direct and indirect SARS-CoV-2 triggered endothelial exocytosis could be responsible for widespread thrombosis and hyper-inflammation seen in patients with severe COVID-19, proposing that endothelial exocytosis releases secretory granules containing von Willebrand factor (VWF) and P-selectin thus causing platelet aggregation and leukocyte adherence, resulting in microvascular obstruction and release of pro-inflammatory cytokines. Authors suggest better understanding the role of endothelial exocytosis by SARS-CoV-2 and underlying mechanisms could provide potential therapeutic targets for novel drug development and drug repurposing.

—Transmission & Prevention: A case series conducted by infectious disease experts at Luigi Sacco University Hospital in Milan, Italy found that among 7 patients persistently carrying SARS-CoV-2, treatment with an Atomix Wave kit to wash their nasopharynx with 3% H2O2 solution for 14 days resulted in negative nasopharyngeal SARS-CoV-2 swabs for at least the first 48 hours (one patient tested weakly positive at 72 hours, and four tested weakly positive at day 7) and up to the full 14 days (2 patients). This study indicates that H2O2 washes could be used to disrupt viral shedding, and further studies with more intensive nasopharyngeal washing are required to determine if better viral

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