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COVID 19: Hot Topics and Lit Review

Tom Robertson, MD and Steve Biederman, MD
00:00
23:04

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There are so many active threads, subthreads, and sub-sub-threads of conversation in the medical community surrounding the COVID-19 pandemic. In this Hippo Education Short, Drs. Tom Robertson and Steve Biederman of Primary Care RAP’s Paper Chase take 4 hot topics in COVID-19 and examine the literature behind them. They look into the epidemiology of the outbreak in the U.S. and lessons learned, the sensitivity and specificity of SARS-CoV-2 testing, the rates of co-infection with other respiratory viruses, and convalescent plasma as a potential therapy.

References:

  1. McMichael TM, Currie DW, Clark C, et al for the CDC COVID-19 Investigation Team. Epidemiology of COVID-19 in a long-term care facility in King County, Washington. N Engl J Med. Published online March 27, 2020. doi:10.1056/NEJMoa2005412

  2. Wang W, Xu Y, Gao R, et al. Detection of SARS-CoV-2 in different types of clinical specimens. JAMA. Published online March 11, 2020. doi:10.1001/jama.2020.3786

  3. Lauer SA, Grantz KH, Bi Q, et al. The incubation period of coronavirus disease 2019 (COVID-19) from publicly reported confirmed cases: estimation and application. Ann Intern Med. Published online March 10, 2020. doi: 10.7326/M20-0504

  4. Shah N. Higher co-infection rates in COVID-19. Data from Stanford University published in Medium at the request of the California Department of Public Health. Published March 18, 2020. https://medium.com/@nigam/higher-co-infection-rates-in-covid19-b24965088333

  5. Ding Q, Lu P, Fan Y. The clinical characteristics of pneumonia patients coinfected with 2019 novel coronavirus and influenza virus in Wuhan, China. J Med Virol. 2020; 1– 7. https://doi.org/10.1002/jmv.25781

  6. Yang Y, Yang M, Shen C, et al. Evaluating the accuracy of different respiratory specimens in the laboratory diagnosis and monitoring the viral shedding of 2019-nCoV infections. medRxiv. 2020 Feb 17;2020.02.11.20021493.

  7. Wolfel R, Corman VM, Guggemos W, et al. Clinical presentation and virological assessment of hospitalized cases of coronavirus disease 2019 in a travel-associated transmission cluster [Internet]. Infectious Diseases (except HIV/AIDS); 2020 Mar. Available from: http://medrxiv.org/lookup/doi/10.1101/2020.03.05.20030502

  8. Ai T, Yang Z, Hou H, et al. Correlation of chest CT and RT-PCR testing in coronavirus disease 2019 (COVID-19) in China: a report of 1014 cases. Radiology. Published online February 26, 2020. https://doi.org/10.1148/radiol.2020200642 

  9. Shen C, Wang Z, Zhao F, et al. Treatment of 5 critically ill patients with COVID-19 with convalescent plasma. JAMA. Published online March 27, 2020. doi:10.1001/jama.2020.4783

Ian L., Dr -

Another paper April 6 describes 10 patients treated with convalescent serum who had severe disease all who responded in 1-3 days .
Kai Duan Bende Lui et al -Proceedings National Academy Sciences USA April 6 2020.
With regard to swabs in a letter to NEngl J M March 19 2020 Lirong Zou et al reported on the nasal and throat swabs. Of 17 symptomatic patients and throat high viral loads detected in the nose swab more than throat .
Nose swab is easier and patients can self swab as reported in "Effectiveness of Patient Collected Swabs for Influenza testing by Neelam Dhiman et al of self collected. Mid Turbinate Swabs -Mayo Clinic Proc 2012 Jun 87(6)548-554 .

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