During the COVID-19 pandemic, have there been more deaths of any cause than would have been expected based on the death rate in previous years?
Bottom Line: From March 1 through to May 30, 2020 there were 120,000 more deaths than would have been expected based on previous years, with roughly 80% of these extra deaths being due to COVID-19 and 20% being due to causes other than COVID-19. Reference: Weinberger, D.M. et al. Estimation of excess deaths associated with the […]
Bottom Line: Older age and medications called immune checkpoint inhibitors are associated with more severe COVID-19 infections in patients with cancer. Reference: Robilotti, E.V. et al. Determinants of COVID-19 disease severity in patients with cancer. Nat Med (2020). https://doi.org/10.1038/s41591-020-0979-0 Date Published: 24 June 2020 Synopsis: Previous studies have shown that patients with cancer have a higher risk of death […]
How did adolescents view COVID-19 at the start of the pandemic, and how did their attitudes shape their associated behaviors?
Bottom Line: The majority of adolescents did not practice physical distancing, but did practice disinfecting behaviors and followed COVID-related news. Those who viewed the virus as more severe were significantly more likely to follow the news, practice physical distancing, and disinfecting behaviors. Reference: Oosterhoff, B. & Palmer, C.A. Attitudes and psychological factors associated with news monitoring, social […]
Bottom Line: Cerebrovascular events, altered mental status, and peripheral neurologic syndromes have been noted in some patients affected by COVID-19. Although this link has been seen, more research is needed to understand why these syndromes occur, and potential risk factors leading to them. Reference: Varatharaj, A. et al. Neurological and neuropsychiatric complications of COVID-19 in 153 […]
Does the use of statins, a cholesterol-lowering medication, have therapeutic effects on patients with COVID-19?
Bottom Line: This study found that the use of statins was associated with reduced severity and lower risk of mortality in COVID-19 patients. However, due to the limitations of the study, these results must be interpreted with caution and further studies must be conducted to confirm the therapeutic potential of statins on COVID-19 outcomes. Reference: […]
Does treatment with tocilizumab in patients with severe COVID-19 pneumonia lead to better outcomes than treatment with standard of care alone?
Bottom Line: Treatment with tocilizumab can potentially reduce the risk of mechanical ventilation and death in patients with severe COVID-19 pneumonia. Reference: Guaraldi, G. et al. Tocilizumab in patients with severe COVID-19: a retrospective cohort study. The Lancet Rheumatology (2020). https://doi.org/10.1016/S2665-9913(20)30173-9 Date Published: 24 June 2020 Synopsis: In severe cases, COVID-19 can cause pneumonia that may lead […]
Bottom Line: Colchicine may slow disease progression in patients with severe COVID-19. Reference: Deftereos, S.G. et al. Effect of colchicine vs standard care on cardiac and inflammatory biomarkers and clinical outcomes in patients hospitalized with coronavirus disease 2019. JAMA Network Open (2020). https://doi.org/10.1001/jamanetworkopen.2020.13136 Date Published: 24 June 2020 Synopsis: Systemic inflammation plays a role in disease progression […]
What is the proportion of essential workers in the United States, and what proportion of essential workers live in households with higher-risk populations?
Bottom Line: 40% of workers in the United States were classified as essential workers, and 51% of households had at least 1 essential worker. Nearly half of essential workers lived in a household with moderate risk, while over 1 in 10 essential workers lived in higher-risk households. Reference: McCormack, G. et al. Economic vulnerability of households […]
What are the clinical effects of the anti-inflammatory medication tocilizumab on patients with COVID-19?
Bottom Line: The use tocilizumab was associated with lower mortality; however, tocilizumab did not show improvement in patients with severe to critical COVID-19. Reference: Rojas-Marte, G.R. et al. Outcomes in patients with severe COVID-19 disease treated with Tocilizumab – A case- Controlled study. QJM: An International Journal of Medicine (2020). https://doi.org/10.1093/qjmed/hcaa206 Date Published: 22 June 2020 Synopsis: The […]
Can a ‘safety grading system’ for shops and businesses improve public safety as economies begin to re-open?
Bottom Line: A safety grading system, in which shops and businesses are inspected and assigned a grade based on their use of COVID-19 safety precautions is a potentially effective strategy to safeguard public health as economies re-open. Reference: Rafferty, M. et al. COVID-19 Safety Grades for Businesses—A Possible Mitigation Tool. JAMA Health Forum (2020). https://jamanetwork.com/channels/health-forum/fullarticle/2767689 Date […]
How do we provide proper psychological support for individuals with adjustment disorder following COVID-19?
Bottom Line: Life stressors associated with COVID-19 could lead to high rates of adjustment disorder, a serious mental health condition which cannot be overlooked amidst the pandemic. Research findings in this area should be applied to help populations on a large scale. Reference: Kazlauskas, E. & Quero, S. Adjustment and Coronavirus: How to Prepare for […]
Bottom Line: Over the course of the social distancing measures, individuals in this study felt increased support. Additionally, older individuals felt less lonely overall, when compared to their younger counterparts. Reference: Luchetti, M. et al. The Trajectory of Loneliness in Response to COVID-19. Am Psychol (2020). https://doi.org/10.1037/amp0000690 Date Published: 22 June 2020 Synopsis: This study aimed […]
What should be the proposed approach to COVID-19 patients with skin disorders, especially those using immunomodulators?
Bottom Line: This study discovered that patients with skin disorders do not have more severe symptoms of COVID-19. Patients are recommended to stop their previous medications until they are no longer symptomatic. Reference: Nobar, N.N. et al. Patients With Specific Skin Disorders Who Are Affected by COVID-19: What Do Experiences Say About Management Strategies? : […]
Bottom Line: The WHO advises that governments should apply a risk-based approach when encouraging the general public to wear masks in specific situations and settings as part of a comprehensive approach to curb COVID-19 transmission. Reference: Advice on the use of masks in the context of COVID-19. World Health Organization (2020). https://apps.who.int/iris/rest/bitstreams/1279750/retrieve Date Published: 5 June […]
Bottom Line: Genetics play a role in how patients respond to COVID-19. For instance, type A blood may put patients at a greater risk for developing severe disease, while type O blood may be protective. Reference: Ellinghaus, D. et al. Genomewide Association Study of Severe Covid-19 with Respiratory Failure. New England Journal of Medicine (2020). https://doi.org/10.1056/nejmoa2020283 […]
What are the characteristics of patients who preferred telemedicine versus in-person visits, prior to COVID-19?
Bottom Line: This study suggests that there are important socio-demographic differences between patients who prefer in-person primary care visits instead of telemedicine. Patients were more likely to prefer in-person visits if they were: age 65 and over, non-English speakers, and living in neighborhoods with less internet access. Reference: Reed, M.E. et al. Patient characteristics associated with […]
Bottom Line: Some patients with COVID-19 experience rashes, hives and itching without any specific dermatological signs, commonly around the trunk area. Reference: Dalal, A. et al. Dermatological findings in SARS‐CoV ‐2 positive patients: An observational study from North India. Dermatologic Therapy (2020). https://doi.org/10.1111/dth.13849 Date Published: 16 June 2020 Synopsis: The clinical symptoms of COVID-19 are wide and encompass […]
How has the COVID-19 pandemic affected physical activity, sleep, alcohol consumption and tobacco use in Australian adults?
Bottom Line: This study found that the COVID-19 pandemic was associated with changes in physical activity, stress, depression, sleep quality, smoking rates in current smokers, and alcohol intake in many people. Reference: Stanton, R. et al. Depression, Anxiety and Stress During COVID-19: Associations With Changes in Physical Activity, Sleep, Tobacco and Alcohol Use in Australian […]
Does natalizumab, a medication used to treat multiple sclerosis, have potential for producing therapeutic effects against COVID-19?
Bottom Line: This is the first case report to propose the potential use of natalizumab, an effective treatment for multiple sclerosis, in preventing the binding of COVID-19 to human cells. Reference: Aguirre, C. et al. Covid-19 in a patient with multiple sclerosis treated with natalizumab: May the blockade of integrins have a protective role? Multiple […]
Bottom Line: It is uncommon for a newborn to be infected with COVID-19, and the risk of infection is no higher if the baby is born vaginally, breastfed, or allowed contact with the mother. Reference: Walker, K. et al. Maternal transmission of SARS‐COV‐2 to the neonate, and possible routes for such transmission: A systematic review and […]
Bottom Line: Mathematical modelling data suggests that widespread adoption of facemasks by the public can prevent subsequent waves of COVID-19. Reference: Stutt, R.O.J.H. et al. A modelling framework to assess the likely effectiveness of facemasks in combination with ‘lock-down’ in managing the COVID-19 pandemic. Proceedings of the Royal Society A: Mathematical, Physical and Engineering Sciences (2020). https://doi.org/10.1098/rspa.2020.0376 Date […]
Bottom Line: Melatonin has been used to treat respiratory diseases in the past due to its anti-inflammatory and anti-oxidant effects, and may be a valuable component in the treatment of COVID-19. Reference: Zhang, R. et al. COVID-19: Melatonin as a potential adjuvant treatment. Life Sciences (2020). https://doi.org/10.1016/j.lfs.2020.117583 Date Published: 23 March 2020 Synopsis: Melatonin is a hormone produced […]
Bottom Line: Occurrence of COVID-19 is impacted by temperature and climate, where higher temperatures and levels of humidity are linked to lower incidence of COVID-19. However, greater sunshine exposure is also linked to increased rates of COVID-19. Reference: Paez, A. et al. A spatio‐temporal analysis of the environmental correlates of COVID‐19 incidence in Spain. Geographical Analysis (2020). https://doi.org/10.1111/gean.12241 […]
Bottom Line: When combined with adjuvant therapy, Arbidol has shown to accelerate recovery in COVID-19 patients. Reference: Chen, W. et al. A study on clinical effect of Arbidol combined with adjuvant therapy on COVID‐19. Journal of Medical Virology (2020). https://doi.org/10.1002/jmv.26142 Date Published: 8 June 2020 Synopsis: Arbidol (ARB) is an anti-viral medication that has been used therapeutically during […]
Can treatments that suppress immune system activity help treat patients with severe COVID-19 disease?
Bottom Line: In severe COVID-19 disease, the immune system becomes overactivated which generates excessive inflammation. Therefore, therapies that decrease immune system activity may improve the health of these patients. Reference: Ye, Q., Wang, B. & Mao, J. The pathogenesis and treatment of the `Cytokine storm’ in COVID-19. Journal of Infection (2020). https://doi.org/10.1016/j.jinf.2020.03.037 Date Published: 10 April 2020 Synopsis: The immune system […]
Bottom Line: The likelihood that approximately 40% to 45% of those infected with SARS-CoV-2 will remain asymptomatic suggests that the virus might have greater potential than previously estimated to spread silently and deeply through human populations. Reference: Oran, D.P. et al. Prevalence of Asymptomatic SARS-CoV-2 Infection. Annals of Internal Medicine (2020). https://doi.org/10.7326/M20-3012 Date Published: 3 June 2020 […]
Bottom Line: COVID-19 patients below the age of 1 generally had mild symptoms and a good prognosis, with the main clinical signs being cough and fever. Reference: Sun, D. et al. SARS-CoV-2 Infection in Infants Under 1 Year of Age in Wuhan City, China. World J Pediatr (2020). https://doi.org/10.1007/s12519-020-00368-y Date Published: 5 June 2020 Synopsis: This study […]
Bottom Line: The study suggests that high-dose oral famotidine results in an improvement of symptoms within 24-48 hours in non-hospitalized COVID-19 patients with minimal adverse effects. Reference: Janowitz, T. et al. Famotidine use and quantitative symptom tracking for COVID-19 in non-hospitalised patients: a case series. Gut (2020). https://doi.org/10.1136/gutjnl-2020-321852 Date Published: 4 June 2020 Synopsis: While most of the […]
What is the best way to re-introduce social networks while continuing to practice social distancing in a post-lockdown world?
Bottom Line: Maintaining social networks may be an effective and more practical way of reducing the spread of COVID-19 compared to current social distancing practices. Reference: Block, P. et al. Social network-based distancing strategies to flatten the COVID-19 curve in a post-lockdown world. Nature Human Behaviour (2020). https://doi.org/10.1038/s41562-020-0898-6 Date Published: 4 June 2020 Synopsis: Recently, many jurisdictions have […]
What were the mental health outcomes of health care workers who provided care during the days immediately preceding the COVID-19 peak in Italy?
Bottom Line: Health care workers in Italy experienced post traumatic stress syndrome, depression, anxiety, insomnia, and stress while providing care during the peak of COVID-19. Women and younger workers were more likely to report mental health symptoms. Reference: Rossi, R. et al. Mental Health Outcomes Among Frontline and Second-Line Health Care Workers During The Coronavirus Disease […]
Bottom Line: Pregnant women presenting with severe COVID-19 infections are at risk for pregnancy complications related to high blood pressure and abnormal kidney and liver functions. Reference: Mendoza, M. et al. Preeclampsia‐like syndrome induced by severe COVID‐19: a prospective observational study. BJOG: An International Journal of Obstetrics & Gynaecology (2020). https://doi.org/10.1111/1471-0528.16339 Date Published: 1 June 2020 Synopsis: A […]
How have public health measures in Canada influenced the physical activity and well-being of the population?
Bottom Line: This study found that there was variability in the changes of activity habits of Canadians due to the COVID-19 outbreak. Reduced levels of activity, in addition to reduced moderate to vigorous exercise, were associated with a decreased state of well-being and increased anxiety levels. Reference: Lesser, I.A. et al. The Impact of COVID-19 […]
Bottom Line: The influenza vaccine does not increase the risk of non-influenza respiratory viruses (NIRV), including seasonal coronaviruses, in Canada. Reference: Skowronski, D.M. et al. Influenza vaccine does not increase the risk of coronavirus or other non-influenza respiratory viruses: retrospective analysis from Canada, 2010-11 to 2016-17.Clinical Infectious Diseases (2020). DOI:10.1093/cid/ciaa626 Date Published: 22 May 2020 […]
Can behavioral changes observed in COVID-19 patients be explained by primary viral invasion of the brain?
Bottom Line: Since behavioral changes can be the first presentation in patients with COVID-19, it may be beneficial to expand screening criteria to include neurological symptoms. Reference: Beach, S. et al. Delirium in COVID-19: A case series and exploration of potential mechanisms for central nervous system involvement. General Hospital Psychiatry (2020). DOI: 10.1016/j.genhosppsych.2020.05.008 Date Published: […]
Bottom Line: All patients undergoing gynecologic surgery during the pandemic need to have a health risk assessment performed before any type of surgery and patients with confirmed or suspected infections should postpone their surgeries until they have fully recovered from the active infection. Reference: Chiofalo, B. et al. Practical Recommendations for Gynecologic Surgery During the […]
Can a machine learning program use chest CT with clinical symptoms to augment early detection of SARS-CoV-2 infection?
Bottom Line: Artificial intelligence can help diagnose COVID-19 in patients with equal sensitivity to a senior radiologist, allowing rapid diagnosis particularly when there is a shortage of RT–PCR test kits. Reference: Mei, X. et al. Artificial intelligence–enabled rapid diagnosis of patients with COVID-19. Nature Medicine (2020). https://doi.org/10.1038/s41591-020-0931-3 Date Published: 19 May 2020 Synopsis: Current diagnosis […]
Bottom Line: Differences in in-hospital mortality to COVID-19 between white and black patients reflect racial differences in the types of jobs with increased risk of community exposure, socioeconomic status, prevalence of chronic conditions, and characteristics of initial clinical presentation . Reference: Price-Haywood, E.G. et al. Hospitalization and Mortality among Black Patients and White Patients with […]
Bottom Line: Currently, the scientific literature does not have enough evidence to suggest specific side-effects to using anti-cancer drugs in combination with COVID-19 therapies. There are some drugs that should be avoided to avoid side effects and interactions with COVID-19 drugs but more research needs to be done to determine how these cancer drugs interact […]
Is a 5-day treatment course with the SARS-CoV-2 drug ‘remdesivir’ as effective as a 10-day treatment course?
Bottom Line: The 5-day remdesivir treatment was as effective as the 10-day treatment course at improving COVID-19 patients’ health. In addition, both treatment durations had a similar frequency of side effects. Reference: Goldman, J.D. et al. Remdesivir for 5 or 10 Days in Patients with Severe Covid-19. New England Journal of Medicine (2020). https://doi.org/10.1056/nejmoa2015301 Date Published: […]
Bottom Line: Autopsy findings of lungs from patients with COVID-19 show distinctive changes to their blood vessels compared to patients with influenza, suggesting that COVID-19 may cause a different disease process. Reference: Ackermann, M. et al. Pulmonary vascular endothelialitis, thrombosis, and angiogenesis in COVID-19. New England Journal of Medicine (2020). https://doi.org/10.1056/nejmoa2015432 Date Published: 21 May 2020 Synopsis: Most […]
Bottom Line: Around 1% (110 of 9,684) of healthcare workers tested positive for COVID-19 but the rate was not consistent across all healthcare workers. Women, nurses under 45 years of age, and those working in non-COVID areas had significantly higher rates of infection. Reference: Lai, X. et al. Coronavirus disease 2019 (COVID-2019) infection among health care […]
Bottom Line: Levels of the COVID-19 virus were consistently high in saliva, particularly in the early stages of the disease. Reference: Yoon, J.G. et al. Clinical significance of a high SARS-Cov-2 viral load in the saliva. Journal of Korean Medical Science (2020). https://doi.org/10.3346/jkms.2020.35.e195 Date Published: 25 May 2020 Synopsis: Patients can unknowingly spread the COVID-19 virus to others […]
Bottom Line: Patients with underlying cardiovascular disease were at an increased likelihood of developing abnormalities of liver function, certain laboratory tests, and more critical illness. Reference: Zhang, J. et al. Do Underlying Cardiovascular Diseases Have Any Impact on Hospitalised Patients With COVID-19?. Heart (2020). DOI: 10.1136/heartjnl-2020-316909 Date Published: 25 May 2020 Synopsis: This study found that […]
Bottom Line: Serologic testing estimates that at the time of the study, about 367,000 adults in Los Angeles County may have had antibodies to SARS-CoV-2, despite only having 8,430 confirmed cases in the area. Reference: Sood, N. et al. Seroprevalence of SARS-CoV-2–Specific Antibodies Among Adults in Los Angeles County, California, on April 10-11, 2020. JAMA (2020). […]
Bottom Line: This study found that a history of lung irradiation increases mortality risk in COVID-19 patients. Reference: Kabarriti, R. et al. Extent of prior lung irradiation and mortality in COVID-19 patients with a cancer history. Advances in Radiation Oncology (2020). https://doi.org/10.1016/j.adro.2020.04.028 Date Published: 20 May 2020 Synopsis: The study gathered 107 patients who tested positive […]
Bottom Line: Children may develop heart failure due to a severe inflammatory state caused by SARS-CoV-2 infection called multisystem inflammatory syndrome in children (MIS-C). Reference: Belhadjer, Z. et al. Acute heart failure in multisystem inflammatory syndrome in children (MIS-C) in the context of global SARS-CoV-2 pandemic. Circulation (2020). https://doi.org/10.1161/CIRCULATIONAHA.120.048360 Date Published: 17 May 2020 Synopsis: Typically, […]
Bottom Line: Monkeys infected with SARS-CoV-2 develop immunity that protects them from re-infection from the virus. Reference: Chandrashekar, A. et al. SARS-CoV-2 infection protects against rechallenge in rhesus macaques. Science (2020). https://doi.org/10.1126/science.abc4776 Date Published: 20 May 2020 Synopsis: It is currently not known whether infection with SARS-CoV-2 provides protective immunity to re-exposure to the virus. To […]
Bottom Line: This study found that the most commonly experienced clinical symptoms among children under the age of 18 were fever, cough, and sore throat. Additionally, symptoms were less severe, compared to adults, as approximately 95% of cases either didn’t have symptoms, or only had mild to moderate symptoms from infection with COVID-19. Reference: Liguro, I. […]
What level of personal protective equipment is needed to protect healthcare workers treating COVID-19?
Bottom Line: Although limited evidence is available, the results of this study suggest that healthcare workers directly exposed to COVID-19 should follow more aggressive protection measures, including the use of respirators (N95 masks) instead of the use of surgical masks. Reference: Bahl, P. et al. Airborne or droplet precautions for health workers treating coronavirus disease 2019? The […]
Bottom Line: Treatment with interferon-a2b antiviral therapy significantly reduced inflammatory proteins and increased viral clearance in patients with COVID-19. Reference: Zhou, Q. et al. Interferon-α2b treatment for COVID-19. Frontiers in Immunology, (2020). https://doi.org/10.3389/fimmu.2020.01061 Date Published: 15 May 2020 Synopsis: With the absence of an approved vaccine against COVID-19, the effectiveness of various antiviral therapies is currently being investigated. One […]
Bottom Line: This study found that when comparing the bordering counties of two U.S. states where one issued stay-at-home orders (Illinois) and the other did not (Iowa), there was an increase in the estimated rates of COVID-19 cases in Iowa counties, compared with Illinois counties. Reference: Lyu, W. & Wehby, G.L. Comparison of estimated rates of coronavirus […]
Bottom Line: This study confirms that COVID-19 can cause severe illness in children but not as severe as in adult patients. Similar to adult COVID-19 patients, severe disease in children is associated with pre-existing comorbidities. Reference: Shekerdemian, L. et al. Characteristics and Outcomes of Children With Coronavirus Disease 2019 (COVID-19) Infection Admitted to US and […]
Bottom Line: There is currently not enough evidence to support the use of azithromycin for the treatment of COVID-19. Reference: Gbinigie, K. et al. Should azithromycin be used to treat COVID-19? A rapid review BJGP Open (2020). DOI: 10.3399/bjgpopen20X101094 Date Published: 12 May 2020 Synopsis: The researchers sought to summarize current scientific knowledge regarding the […]
Bottom Line: Initial evidence suggests potential improvement in oxygenation and reduced lung injury from patients adopting the prone position (lying face down and back up) in spontaneous and assisted breathing. Reference: Telias, I. et al. Is the Prone Position Helpful During Spontaneous Breathing in Patients With COVID-19? JAMA (2020). DOI:10.1001/jama.2020.8539 Date Published: 15 May 2020 […]
Are COVID-19 infection rates and severity different between patients who have received BCG vaccinations compared to those who have not?
Bottom Line: There was no statistically significant difference in the proportion of patients with COVID-19 positive test results in the BCG-vaccinated group compared to the unvaccinated group Reference: Hamiel, U. et al. SARS-CoV-2 rates in BCG-vaccinated and unvaccinated young adults. JAMA (2020). DOI:10.1001/jama.2020.8189 Date Published: 13 May 2020 Synopsis: A potential reason for varied infection […]
Bottom Line: Patients with spinal cord injury and a COVID-19 infection show fewer symptoms than the general population but present with similar or worse severity. Reference: Rodriguez-Cola, M. et al. Clinical features of coronavirus disease 2019 (COVID-19) in a cohort of patients with disability due to spinal cord injury. Spinal Cord Series and Cases (2020). […]
Is there an association between the current coronavirus epidemic and Kawasaki disease, a rare inflammatory disorder in children?
Bottom Line: There has been a 30-fold increased incidence of severe Kawasaki disease in Italy since the SARS-CoV-2 epidemic began. Reference: Verdoni, L. et al. An outbreak of severe Kawasaki-like disease at the Italian epicentre of the SARS-Cov-2 epidemic: An observational cohort study. The Lancet (2020). https://doi.org/10.1016/S0140-6736(20)31103-X Date Published: 13 May 2020 Synopsis: Kawasaki disease is a rare […]
Bottom Line: Transmission of COVID-19 is highest before and soon after symptom onset, and that isolation of symptomatic patients is not a sufficient mitigation strategy when used alone. Reference: Cheng, H. et al. Contact Tracing Assessment of COVID-19 Transmission Dynamics in Taiwan and Risk at Different Exposure Periods Before and After Symptom Onset. JAMA Internal Medicine (2020). […]
Bottom Line: There is growing evidence that COVID-19 disproportionately affects individuals from black, Asian, and minority ethnic (BAME) communities. Reference: Kirby, T. et al. Evidence mounts on the disproportionate effect of COVID-19 on ethnic minorities. The Lancet (2020). DOI: 10.1016/S2213-2600(20)30228-9 Date Published: 8 May 2020 Synopsis: Several research articles have described ethnic minorities as being more likely […]
Bottom Line: Public health measures such as social distancing and school closures substantially reduce COVID-19 growth, while climate factors such as humidity and temperature have little to no effect on the growth rate of COVID-19. Reference: Peter, J. et al. Impact of climate and public health interventions on the COVID-19 pandemic: A prospective cohort study. CMAJ (2020). […]
Bottom Line: An antiviral trial therapy that combines interferon beta-1b, lopinavir-ritonavir and ribavirin has been shown to effectively alleviate symptoms and shorten viral replication in patients with COVID-19. Reference: Hung, I. F.-N. et al. Triple combination of interferon beta-1b, lopinavir–ritonavir, and ribavirin in the treatment of patients admitted to hospital with COVID-19: an open-label, randomised, […]
Bottom Line: Researchers found that older age and a decreased lymphocyte count (a measure of a specific type of white blood cell) were both associated with patient death relating to COVID-19. Reference: Sun, H. et al. Risk Factors for Mortality in 244 Older Adults With COVID-19 in Wuhan, China: A Retrospective Study. Journal of the […]
Bottom Line: The skin rash seen in a patient with COVID-19 has similar features to skin rashes caused by other viral infections such as parvovirus B19 or pityriasis rosea, and may be produced by a similar pathway. Reference: Diaz-Guimaraens, B. et al. Petechial Skin Rash Associated with Severe Acute Respiratory Syndrome Coronavirus 2 Infection. JAMA […]
Bottom Line: In 1,446 patients hospitalized with COVID-19, hydroxychloroquine administration was not associated with significantly higher or lower risk of death. Reference: Geleris, J. et al. Observational Study of Hydroxychloroquine in Hospitalized Patients with Covid-19. New England Journal of Medicine (2020). DOI: 10.1056/NEJMoa2012410 Date Published: 7 May 2020 Synopsis: The researchers performed an observational study […]
Bottom Line: Diabetes mellitus (DM) can lead to poor outcomes in patients with COVID-19 due to a compromised immune system, inflammation, and use of certain medications (e.g. RAAS antagonists). Conversely, in patients who have diabetes mellitus, a COVID-19 infection can worsen glucose control because of the drugs used to treat the infection (e.g. corticosteroids, lopinavir/ritonavir), […]
Bottom Line: The authors describe a case of a 6-month old infant without respiratory symptoms who was diagnosed with both COVID-19 and Kawasaki disease, suggesting possible association between the two diseases. Reference: Jones, V.G. et al. COVID-19 and Kawasaki Disease: Novel Virus and Novel Case. Hospital Pediatrics (2020). DOI: 10.1542/hpeds.2020-0123. Available from: https://hosppeds.aappublications.org/content/early/2020/04/06/hpeds.2020-0123 Date Published: […]
How did the endorsement of unproven treatments by high-profile figures impact individuals’ treatment decision-making?
Bottom Line: Medication endorsement by non-expert, high-profile figures may impact people’s treatment decisions. Even with an absence of evidence regarding treatment effectiveness, Google searches for chloroquine and hydroxychloroquine were significantly higher than expected between March 16 and March 29, during which time both Elon Musk and U.S. President Donald Trump endorsed these treatments. Reference: Liu, […]
Are two commonly used blood pressure medications associated with an increased or decreased risk of COVID-19?
Bottom Line: Although the use of angiotensin-receptor blockers (ARBs) and angiotensin-converting enzyme (ACE) inhibitors are more frequent in patients with COVID-19 due to a higher burden of cardiovascular disease, there is no evidence showing that their use is associated with a higher or lower risk of developing COVID-19. Reference: Mancia, G. et al. Renin–Angiotensin–Aldosterone System […]
Bottom Line: From a public health perspective, COVID-19 outcomes are suggested to be influenced by underlying comorbidities of the population, occupational exposures, socioeconomic determinants, and race-based structural inequalities. Reference: Wadhera, R. et al. Variation in COVID-19 Hospitalizations and Deaths Across New York City Boroughs. JAMA (2020). DOI: 10.1001/jama.2020.7197 Date Published: 29 April 2020 Synopsis: This […]
Bottom Line: This study compiled data from 166 countries, and found that increases in both temperature and humidity were associated with reduced rates of new daily cases and deaths from COVID-19. Reference: Wu, Y. et al. Effects of temperature and humidity on the daily new cases and new deaths of COVID-19 in 166 countries. Science […]
Bottom Line: Measuring two kinds of antibodies (IgG and IgM) may be useful in early COVID-19 diagnosis. Reference: Zhang, G. et al. Longitudinal Change of SARS-Cov2 Antibodies in Patients with COVID-19. Journal of Infectious Diseases (2020). DOI: 10.1093/infdis/jiaa229 Date Published: 2 May 2020 Synopsis: Antibodies are immune molecules in our bodies that form against a […]
Bottom Line: According to data from the Coronavirus Infection in Pediatric Emergency Departments (CONFIDENCE) study and three additional studies, most children with COVID-19 had exposure to SARS-CoV-2 from an unknown source or source outside the child’s family, developed mild to moderate disease, and did not require respiratory support. Reference: Parri, N. et al. Children with […]
Bottom Line: A study of 1099 patients diagnosed with COVID-19 in China found that the patients commonly experienced cough and fever, had abnormal medical imaging results, and developed pneumonia. Reference: Guan, W. et al. Clinical Characteristics of Coronavirus Disease 2019 in China. New England Journal of Medicine (2020). https://doi.org/10.1056/nejmoa2002032 Date Published: 30 April 2020 Synopsis: This […]
Bottom Line: In adults who are severely sick with COVID-19, treatment with remdesivir has not been shown to improve clinical outcomes (defined as an improvement in the patient’s health after 28 days). Reference: Wang, Y. et al. Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial. The Lancet (2020). https://doi.org/10.1016/s0140-6736(20)31022-9 Date Published: 29 […]
Bottom Line: Researchers have identified 69 compounds which may be effective in targeting SARS-CoV-2 including 29 FDA-approved drugs, 12 drugs in clinical trials and 28 preclinical compounds. Reference: Gordon, D.E. et al. A SARS-CoV-2 protein interaction map reveals targets for drug repurposing. Nature (2020). DOI: 10.1038/s41586-020-2286-9 Date Published: 30 April 2020 Synopsis: In this article, […]
What considerations and infection precautions need to be taken for trauma and acute care surgeries during the pandemic?
Bottom Line: For patients with suspected or confirmed COVID-19, any emergency surgery should be carried out with the appropriate infection precautions, proper screening before the surgery and conducted in a negative pressure operating room. After any emergency surgery, all patients should be monitored closely for infection and anticoagulation therapy is recommended for trauma patients with […]
Bottom Line: Communities of colour face increased financial and health risks associated with COVID-19 due to economic and social circumstances. Reference: Artiga, S. et al. Communities of Color at Higher Risk for Health and Economic Challenges due to COVID-19. KFF Disparities Policy (2020). Retrieved from: https://www.kff.org/disparities-policy/issue-brief/communities-of-color-at-higher-risk-for-health-and-economic-challenges-due-to-covid-19/ Date Published: 7 April 2020 Synopsis: The COVID-19 outbreak […]
Bottom Line: A study reports that airflow direction in a restaurant was consistent with droplet transmission of COVID-19. Reference: Lu, J. et al. COVID-19 Outbreak Associated with Air Conditioning in Restaurant, Guangzhou, China, 2020. Emerging Infectious Diseases (2020). DOI: 10.3201/eid2607.200764 Date Published: 2 April 2020 Synopsis: The study reports on three COVID-19 family clusters that […]
What were the mental health impacts of COVID-19 on primary school-aged children in the Hubei province of China?
Bottom Line: Children in the Hubei province of China experienced negative mental health impacts during the COVID-19 outbreak. Approximately 1 in 5 students reported depressive and anxiety symptoms. Students living in Wuhan, the epicentre of the outbreak, were more likely to report depressive symptoms. Reference: Xie, X. et al. (2020). Mental health status among children in […]
Bottom Line: Ocular symptoms (i.e. problems related to the eyes) are common and may even appear before the onset of respiratory symptoms in COVID-19 positive patients. Reference: Hong, N. et al. (2020). Evaluation of ocular symptoms and tropism of SARS‐Cov‐2 in patients confirmed with COVID‐19. Acta Ophthalmologica. https://doi.org/10.1111/aos.14445 Date Published: 26 April 2020 Synopsis: Some commonly known symptoms […]
Bottom Line: When infected with COVID-19, Caucasian patients are at higher risk than Chinese patients of developing blood clots. Reference: Fogarty, H. et al. COVID‐19 Coagulopathy in Caucasian patients. British Journal of Haematology (2020). https://doi.org/10.1111/bjh.16749 Date Published: 24 April 2020 Synopsis: Ethnicity is known to have major implications on how readily patients form abnormal blood […]
Bottom Line: Hydroxychloroquine and chloroquine have received attention in the media as an effective treatment for COVID-19, however, a recently published study by Borba et al. in Brazil (terminated early due to excessive serious adverse events) highlights potential concerns when considering their use as treatment in COVID-19 patients. Reference: Fihn, S.D. et al. Caution Needed […]
What are the skin manifestations of COVID-19 and how can they be used as early markers for the disease?
Bottom Line: Skin reactions to COVID-19 are divided into 2 groups: (1) the typical non-specific skin rash as seen in other viral infections; and (2) the purple skin eruptions on the tips of toes and fingers, resulting from potential damage to blood vessels in the skin. Reference: Suchonwanit, P. et al. Cutaneous manifestations in COVID-19: […]
Bottom Line: From preliminary evidence in Boston, it seems like the homeless population is much more susceptible to rapid spread of the virus. Over a 15-day period, the frequency of cases per 1000 persons was 46.3 in the homeless population, versus 1.9 among the general population. Reference: Baggett, T.P. et al. Epidemiology of COVID-19 among […]
Bottom Line: Available data shows that the COVID-19 infection during pregnancy, especially in the final trimester, does pose some risks to the baby but there is no evidence currently of the infection being passed to the baby during the pregnancy. However, it is unknown if passing the infection to the baby is more likely with […]
What can mathematical modelling tell us about the transmission of coronavirus over the upcoming years?
Bottom Line: The data obtained through mathematical modelling tells us that prolonged and intermittent social distancing may be necessary until 2022. Reference: Kissler, S.M. et al. Projecting the Transmission Dynamics of SARS-CoV-2 through the Postpandemic Period. Science (2020). DOI: 10.1126/science.abb5793 Date Published: 14 April 2020 Synopsis: It is currently unknown how SARS-CoV-2 (the virus that […]
How does the structure of the human cell entry protein used by SARS-CoV-2 compare to the same protein used by the SARS-CoV?
Bottom Line: The protein which allows the SARS-CoV-2 virus (the virus that causes COVID-19) to enter human cells (human cell entry protein) is 88% identical to that of the human cell entry protein in SARS-CoV (the virus that caused the 2003 SARS outbreak), the virus responsible for the 2003 SARS outbreak. This finding may provide […]
Bottom Line: COVID-19 can cause many different neurological symptoms, ranging from mild (e.g. headache) to severe (e.g. central nervous system infection). Reference: Liu, K. et al. Neurological manifestations of the coronavirus (SARS-CoV-2) pandemic 2019–2020. Journal of Neurology, Neurosurgery & Psychiatry (2020). https://doi.org/10.1136/jnnp-2020-323177 Date Published: 20 April 2020 Synopsis: Researchers have outlined possible neurological symptoms associated […]
Bottom Line: Patients with higher levels of the blood clotting protein, D-dimer, on admission showed greater incidences of mortality when compared to those with lower levels. Reference: Zhang, L. et al. D‐dimer levels on admission to predict in‐hospital mortality in patients with Covid‐19. Journal of Thrombosis and Haemostasis (2020). https://doi.org/10.1111/jth.14859 Date Published: 19 April 2020 […]
Bottom Line: Emerging evidence points to the involvement of the COVID-19 virus with the cardiovascular system, and patients with existing cardiovascular conditions may be at increased risk of death. Research is being actively performed to better understand how this knowledge may help physicians treat patients with COVID-19, and understand the prognosis of infection in a […]
Do patients with chronic inflammatory diseases have a higher risk for severe infection by COVID-19 due to their medications?
Bottom Line: While there is limited evidence to date, the analysis of inflammatory signalling proteins suggests that most cytokine inhibitors used in treatment of diseases like psoriasis, atopic dermatitis, and inflammatory bowel disease, do not automatically increase the risk of severe COVID-19 infection. Reference: Schett, G. et al. COVID-19: risk for cytokine targeting in chronic […]
Bottom Line: There are currently no proven effective therapies for COVID-19, but several promising candidates are being tested, such as remdesivir. Reference: Sanders, J.M. et al. Pharmacologic Treatments for Coronavirus Disease 2019 (COVID-19). JAMA (2020). doi: 10.1001/jama.2020.6019 Date Published: April 13, 2020 Synopsis: The authors reviewed the present literature to provide an update on current […]
Bottom Line: Yes, 78 of the 214 hospitalized COVID-19 patients studied in Wuhan, China had neurological symptoms, which included: dizziness, headache, lower level of alertness, stroke, imbalance, seizure, loss of taste and smell, changes in vision, nerve pain, and skeletal muscle injury. The symptoms, especially the more severe ones, were more common in patients with […]
Bottom line: COVID-19 has caused a drastic rise in virtual care usage, which carries both benefits—such as avoiding infections that may have occurred at an in-person appointment—and risks, such as technical difficulties and the inability to perform physical examinations. Reference: Webster, P. et al. Virtual health care in the era of COVID-19. The Lancet (2020). […]
What is the association between gastrointestinal symptoms (nausea, vomiting, and diarrhea) and COVID-19?
Bottom Line: In patients who met testing criteria for COVID-19, those with gastrointestinal symptoms were more likely to test positive for COVID-19, and these symptoms may be associated with a slower and less severe disease course. Reference: Nobel, Y.R. et al. Gastrointestinal Symptoms and COVID-19: Case-Control Study from the United States. Gastroenterology (2020). DOI: 10.1053/j.gastro.2020.04.017 […]
Bottom Line: Not only do many COVID-19 patients experience a loss of smell and taste, but recovery from the disease is also correlated with improvements in those sensory symptoms. Reference: Yan, C.H. et al. Association of chemosensory dysfunction and Covid‐19 in patients presenting with influenza‐like symptoms. International Forum of Allergy & Rhinology (2020). DOI: 10.1002/alr.22579 […]
Bottom Line: Through this study, it was found that the mortality rate of older adults with COVID-19 was 34.5%, with symptoms including fever, chest distress, and dry cough. Reference: Chen, T. et al. Clinical characteristics and outcomes of older patients with coronavirus disease 2019 (COVID-19) in Wuhan, China (2019): a single-centered, retrospective study. Journal of […]
Bottom Line: A 10-day course of remdesivir resulted in clinical improvement (measured by oxygen saturation, mortality, discharge from hospitals) in 68% of the patients in this study. Reference: Grien J et al., Compassionate Use of Remdesivir for Patients with Covid-19. New England Journal of Medicine (2020). DOI: 10.1056/NEJMoa2007016 Date Published: 10 April 2020 Synopsis: Remdesivir […]
How should mental health care be prioritized during the ongoing fight against the COVID-19 global pandemic?
Bottom Line: During pandemics, individuals with mental health disorders are particularly vulnerable, and people considered previously mentally well are at risk of developing new psychiatric conditions. Mental health should be a priority when creating public health policies and research plans. Reference: Kaufman, K.R. et al. A global needs assessment in times of a global crisis: […]
Bottom Line: The use of new vaccine development technologies and a ‘parallel approach’ to development, in which multiple steps of vaccine production are carried out simultaneously, could substantially increase the speed of vaccine production. Reference: Lurie N et al. Developing Covid-19 Vaccines at Pandemic Speed. New England Journal of Medicine (2020). DOI: 10.1056/NEJMp2005630 Date Published: […]