Title: Extra-respiratory manifestations of COVID-19 Publisher: International Journal of Antimicrobial Agents Publication Date: May 25, 2020
Key Takeaway: SARS-CoV-2 infection often involves other organs/systems beyond the respiratory system.
Title: Viral Load Dynamics in Patients Infected with SARS-CoV-2
Publisher: NEJM Journal Watch (summarizing articles in BMJ and Eur J Clin Micro Infect Dis)
Publication Date: May 27, 2020
Key Takeaway: This is a report of two recent publications on viral load dynamics in patients recovering from Covid-19 infection. Conclusions:
- Patients with severe COVID-19 shed virus longer and in higher copy numbers.
- Viral shedding appears to last longer in patients with severe disease, in those with corticosteroid treatment, in older individuals, and in men.
- 3.Quantitative RT-PCR and viral infectivity seem to be closely linked.
This information is of value when considering discontinuation of isolation in patients recovering from COVID-19. Unfortunately, the authors did not investigate the association between infectivity and time from symptom onset. Such data are urgently awaited.
Title: What Tests Should No Longer Be Distributed for COVID-19 Serology? Publisher: FDA
Publication Date: May 22, 2020
Key Takeaway: For our laboratory, research and procurement staff, this is an FDA- distributed list of commercial manufacturers of Covid-19 serological tests that no longer should be used. Note: FDA had granted Emergency Use Authorization for distribution and use of Covid-19 serologic tests to a very large number of manufacturers. FDA has now removed many in an attempt to improve quality standards of Covid-19 serologic testing.
Title: COVID-19 and Liver Dysfunction: a systematic review and meta analysis of retrospective studies
Publisher: Journal of Medical Virology Publication Date: May 23, 2020
Key Takeaway: Meta‐analysis of 20 retrospective studies (3428 patients), identified that patients with a severe manifestation of COVID‐19 exhibited significantly higher levels of alanine aminotransferase, aspartate aminotransferase, and bilirubin values with prolonged prothrombin time. Furthermore, lower albumin level was associated with a severe presentation of COVID‐19. Liver dysfunction was associated with a severe outcome of COVID-19 disease. Close monitoring of the occurrence of liver dysfunction is beneficial in early warning of unfavorable outcomes.
Title: Findings from Investigation and analysis of re-positive cases
Publisher: Korean CDC
Publication Date: May 19, 2020
Key Takeaway: Based on active monitoring, epidemiological investigation, and laboratory testing of re-positive cases and their contacts, no evidence was found that indicated infectivity of re-positive cases:
Based on these data, the Korean CDC has updated their protocols to conduct no additional tests for cases that have been discharged from isolation.
Title: Variation in False-Negative Rate of Reverse Transcriptase Polymerase Chain Reaction–Based SARS-CoV-2 Tests by Time Since Exposure
Publisher: Annals of Internal Medicine
Publication Date: May 13, 2020
Key Takeaway: This retrospective modeling study demonstrates the potentially high rate of false negativity of RT-PCR in the pre-symptomatic period of SARS-CoV-2 infection. If confirmed, this would reduce the predictive value of asymptomatic testing as a public health strategy (such as in a population health screening program).
Over the 4 days of infection before the typical time of symptom onset (day 5), the probability of a false-negative result in an infected person decreases from 100% (95% CI, 100% to 100%) on day 1 to 67% (CI, 27% to 94%) on day 4. On the day of symptom onset, the median false-negative rate was 38% (CI, 18% to 65%). This decreased to 20% (CI, 12% to 30%) on day 8 (3 days after symptom onset) then began to increase again, from 21% (CI, 13% to 31%) on day 9 to 66% (CI, 54% to 77%) on day 21.
Title: Viral and host factors related to the clinical outcome of COVID-19
Publication Date: May 20, 2020
Key Takeaway: Genomic sequences of SARS-CoV-2 assembled from 112 quality samples together with sequences in the GISAID showed a stable evolution and suggested two major lineages during the early phase of the outbreak in Wuhan although they exhibited similar virulence and clinical outcomes. The determinants of disease severity seemed to stem mostly from host factors such as age, lymphocytopenia, and its associated cytokine storm, whereas viral genetic variation did not significantly affect the outcomes. Of note, this study only examined samples collected from China January-February. Other studies have shown more genetic diversity in the virus, as would be expected.
Title: Assessment of Specimen Pooling to Conserve SARS CoV-2 Testing Resources.
Publisher: American Journal of Clinical Pathology
Publication Date: April 18, 2020
Key Takeaway: Proof-of-concept study evaluating pooled specimen group RT-PCR testing to detect SARS-Cov-2, to expand testing capacity in the future. Sample pooling has been used in other applications for years. When incidence of SARS-CoV-2 infection is 10% or less, group testing saves reagents and personnel time, increasing testing capability at least 69%.
Title: SARS-CoV-2 Shedding From Asymptomatic Patients: Contribution of Potential Extrapulmonary Tissue Reservoirs
Publisher: American Journal of Tropical Medicine and Hygiene
Publication Date: April 13, 2020
Key Takeaway: Perspective paper, analyzing human and animal studies - prolonged COVID positivity even after symptoms resolved, likely explained by extrapulmonary reservoirs.
Title: Infectious Diseases Society of America Guidelines on the Diagnosis of COVID-19.
Publication Date: May 6, 2020
Key Takeaway: This is the third of 3 IDSA guidelines on COVID, this one deals with diagnosis providing 15 practical recommendations and an associated algorithm for testing, the other two deal with treatment, and infection control.
Title: Society of Cardiovascular Computed Tomography guidance for use of cardiac computed tomography amidst the COVID-19 pandemic
Author affiliated with GW
Publisher: Journal of Cardiovascular Computed Tomography
Publication Date: 21 March 2020
Key Takeaways: The Society of Cardiovascular Computed Tomography offers recommendations for cardiac imaging amidst the COVID-19 pandemic and information on determining the optimal timing of outpatient and inpatient heart imaging exams.
Title: CDC updates COVID-19 laboratory testing FAQs
Publisher: US Centers for Disease Control and Prevention
Publication: April 21, 2020
Title: Developing a National Strategy for Serology (Antibody Testing) in the United States
Publisher: Johns Hopkins Center for Health Security
Publication: April 22, 2020
Serologic testing has the potential to provide valuable information for public health decision-making when conducted as a complement to molecular testing, and is also in demand from individuals and employers to determine perceived immunity.
Title: Pulmonary and Cardiac Pathology in Covid-19: The First Autopsy Series
Publication: April 10, 2020 (not peer-reviewed)
Antibodies in Infants Born to Mothers With COVID-19 Pneumonia