severe acute respiratory syndrome coronavirus 2

Risk of COVID-19 During Air Travel

Advise to breastfeeding mothers exposed to COVID-19. James W. Mold, MD, MPH

Free full text

View

Not available.

Author/s:

Sullivan, S.E., Thompson, L.A.

Risk of COVID-19 During Air Travel

Brian Desmarais — Sat, 03 Oct 2020 18:49:23 +0000

Date Added:

October 3, 2020

Journal/Publication:

Journal of the American Medical Association

Publication Date:

October 1, 2020

URL:

Type:

Patient Education Materials

Format:

Article

DOI (1):

doi:10.1001/jama.2020.19108

MeSH

Pediatric inflammatory multisystem syndrome temporally associated with COVID-19: a spectrum of diseases with many names

Information for patients regarding COVID-19 risk and air travel. Hopefully, it is accurate and not the propaganda from the airline industry. I can’t tell. James W. Mold, MD, MPH

Free full text

View

Not available.

Author/s:

Pombal, Rui, Hosegood, Ian, Powell, David

Pediatric inflammatory multisystem syndrome temporally associated with COVID-19: a spectrum of diseases with many names

Brian Desmarais — Mon, 21 Sep 2020 20:41:25 +0000

Date Added:

September 21, 2020

Journal/Publication:

Canadian Medical Association Journal

Publication Date:

September 9, 2020

URL:

Type:

Meta-analyses, Reviews, and Guidelines, Practice Management Research Results

Format:

Article

DOI (1):

10.1503/cmaj.201600

MeSH

child

23-valent pneumococcal capsular polysaccharide vaccine

Craniosynostoses

Intellectual Disability

6-dimethylaminodibenzopyriodonium citrate

This is a concise summary of the multisystem inflammatory syndrome (MIS-C) seen in some children following infection with COVID-19. James W. Mold, MD, MPH

Free full text

View

No abstract available.

Author/s:

Tam, Herman, Tal, Tala El, Go, Ellen, Yeung, Rae S. M.

Kinetics of viral clearance and antibody production across age groups in SARS-CoV-2 infected children

Brian Desmarais — Sat, 12 Sep 2020 19:39:34 +0000

Date Added:

September 12, 2020

Journal/Publication:

The Journal of Pediatrics

Publication Date:

September 2, 2019

URL:

Kinetics of viral clearance and antibody production across age groups in SARS-CoV-2 infected children

Type:

Clinical Research Results

Format:

Article

DOI (1):

10.1016/j.jpeds.2020.08.078

MeSH

retrospective studies

Antibodies, Neutralizing

Virus Shedding

Hospitals, Pediatric

Severe Acute Respiratory Syndrome

Neutralization Tests

Reverse Transcriptase Polymerase Chain Reaction

Specimen Handling

Antibody Formation

Immunoglobulin G

Children with COVID-19 clear the virus when antibody titers reach a critical level. Until then (several weeks from onset), they continue to have detectable viral particles in their noses. James W. Mold, MD, MPH

Free full text

View

Abstract

Objectives: To improve understanding of transition from viral infection to viral clearance, and antibody response in pediatric patients with SARS-CoV-2 infection.

Study design: This retrospective analysis of children tested for SARS-CoV-2 by RT-PCR and IgG antibody at a quaternary-care, free-standing pediatric hospital between March 13, 2020 to June 21, 2020 included 6369 patients who underwent PCR testing and 215 patients who underwent antibody testing. During the initial study period, testing focused primarily on symptomatic children; the later study period included asymptomatic patients who underwent testing as preadmission or preprocedural screening. We report the proportion of positive and negative tests, time to viral clearance, and time to seropositivity.

Results: The rate of positivity varied over time due to viral circulation in the community and transition from targeted testing of symptomatic patients to more universal screening of hospitalized patients. Median duration of viral shedding (RT-PCR positivity) was 19.5 days and time from RT-PCR positivity to negativity was 25 days. Of note, patients aged 6 through 15 years demonstrated a longer time of RT-PCR positivity to negativity, compared with patients aged 16 through 22 years (median=32 versus 18 days, P = .015). Median time to seropositivity, by chemiluminescent testing, from RT-PCR positivity was 18 days while median time to reach adequate levels of neutralizing antibodies (defined as comparable to 160 titer by plaque reduction neutralization testing) was 36 days.

Conclusions: The majority of patients demonstrated a prolonged period of viral shedding after infection with SARS CoV-2. It is unknown whether this correlates with persistent infectivity. Only 17 of 33 patients demonstrated adequate neutralizing antibodies during the timeframe of specimen collection. It remains unknown if IgG antibody against spike structured proteins correlates with immunity, and how long antibodies and potential protection persist.

Author/s:

Bahar, Burak, Jacquot, Cyril, Mo, Yunchuan D., DeBiasi, Roberta L., Campos, Joseph, Delaney, Meghan

Interim Guidance for Rapid Antigen Testing for SARS-CoV-2

Brian Desmarais — Thu, 20 Aug 2020 14:26:20 +0000

Date Added:

August 20, 2020

Publisher:

Centers for Disease Control and Prevention

Publication Date:

August 16, 2020

URL:

Interim Guidance for Rapid Antigen Testing for SARS-CoV-2

Type:

Public Health Announcements

Format:

Web Page

MeSH

Coronavirus

point-of-care systems

Centers for Disease Control and Prevention

pandemics

Point-Of-Care Testing

U.S.

Interim guidance from the CDC on the use of rapid antigen tests for COVID-19. James W. Mold, MD, MPH

Free full text

View

Not available.

Interim Guidance for Rapid Antigen Testing for SARS-CoV-2

Brian Desmarais — Thu, 20 Aug 2020 14:24:53 +0000

Date Added:

August 20, 2020

Publisher:

Centers for Disease Control and Prevention

Publication Date:

August 16, 2020

URL:

Interim Guidance for Rapid Antigen Testing for SARS-CoV-2

MeSH

Coronavirus

point-of-care systems

SARS-CoV-2 (COVID-19) serology: implications for clinical practice, laboratory medicine and public health

pandemics

Point-Of-Care Testing

Interim guidance from the CDC on the use of rapid antigen tests for COVID-19. James W. Mold, MD, MPH

Free full text

View

Not available.

SARS-CoV-2 (COVID-19) serology: implications for clinical practice, laboratory medicine and public health

Brian Desmarais — Mon, 10 Aug 2020 17:58:44 +0000

Date Added:

August 10, 2020

Journal/Publication:

Canadian Medical Association Journal

Publication Date:

August 3, 2020

URL:

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1503/cmaj.201588

MeSH

Symptom Duration and Risk Factors for Delayed Return to Usual Health Among Outpatients with COVID-19 in a Multistate Health Care Systems Network — United States, March–June 2020

Serologic Tests

Antibodies

A nice review of serological tests for COVID-19 antibodies and recommendations for when to and when not to use them. James W. Mold, MD, MPH

Free full text

View

Not available.

Author/s:

Caeseele, P.V., Bailey, D., Forgie, S.E., Dingle, T.C., Krajden, M.

Symptom Duration and Risk Factors for Delayed Return to Usual Health Among Outpatients with COVID-19 in a Multistate Health Care Systems Network — United States, March–June 2020

Brian Desmarais — Wed, 29 Jul 2020 15:21:15 +0000

Date Added:

July 29, 2020

Publisher:

Centers for Disease Control and Prevention

Publication Date:

July 24, 2020

URL:

Type:

Clinical Research Results

Format:

Article

DOI (1):

http://dx.doi.org/10.15585/mmwr.mm6930e1

MeSH

public health

outpatients

Severe Acute Respiratory Syndrome

Public Health Practice

Telephone

Surveys and Questionnaires

Young Adult

Adults

It often takes a long time to recover from COVID-19. James W. Mold, MD, MPH

Free full text

View

Summary

What is already known about this topic?

Relatively little is known about the clinical course of COVID-19 and return to baseline health for persons with milder, outpatient illness.

What is added by this report?

In a multistate telephone survey of symptomatic adults who had a positive outpatient test result for SARS-CoV-2 infection, 35% had not returned to their usual state of health when interviewed 2–3 weeks after testing. Among persons aged 18–34 years with no chronic medical conditions, one in five had not returned to their usual state of health.

What are the implications for public health practice?

COVID-19 can result in prolonged illness, even among young adults without underlying chronic medical conditions. Effective public health messaging targeting these groups is warranted.

Author/s:

Tenforde, M.W., Kim, S.S., Lindsell, C.J., Rose, E.B.

SARS-CoV-2-related chilblains

Brian Desmarais — Wed, 22 Jul 2020 15:46:09 +0000

Date Added:

July 22, 2020

Publication Date:

July 13, 2020

URL:

SARS-CoV-2-related chilblains

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

https://doi.org/10.1503/cmaj.201348

Keywords

damp cold

MeSH

Chilblains

Guidance on interpreting COVID-19 test results

Chilblains, usually associated with exposure to damp cold, can also be a manifestation of systemic illnesses including COVID 19. James W. Mold, MD, MPH

Free full text

View

Not available.

Author/s:

Ladha, M.A., Dupuis, E.C.

Guidance on interpreting COVID-19 test results

Brian Desmarais — Mon, 13 Jul 2020 16:04:22 +0000

Date Added:

July 13, 2020

Publisher:

Centers for Disease Control and Prevention

Publication Date:

June 24, 2020

URL:

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Web Page

MeSH

Multisystem Inflammatory Syndrome in U.S. Children and Adolescents

Infections

DNA Viruses

Antibodies, Viral

A table with suggestions regarding how to interpret COVID test results based upon type of test and clinical situation. James W. Mold, MD, MPH

Free full text

View

Not available.

Author/s:

Centers for Disease Control and Prevention

Multisystem Inflammatory Syndrome in U.S. Children and Adolescents

Brian Desmarais — Fri, 03 Jul 2020 19:52:28 +0000

Date Added:

July 3, 2020

Journal/Publication:

New England Journal of Medicine

Publication Date:

June 29, 2020

URL:

Type:

Clinical Research Results

Format:

Article

DOI (1):

10.1056/NEJMoa2021680.

MeSH

Centers for Disease Control and Prevention

U.S.

Persistent Value of the Stethoscope in the Age of COVID-19

A summary of the clinical characteristics and clinical course of 186 children with multi-inflammatory syndrome (MIS-C). James W. Mold, MD, MPH

Free full text

View

Abstract

BACKGROUND

Understanding the epidemiology and clinical course of multisystem inflammatory syndrome in children (MIS-C) and its temporal association with coronavirus disease 2019 (Covid-19) is important, given the clinical and public health implications of the syndrome.

METHODS

We conducted targeted surveillance for MIS-C from March 15 to May 20, 2020, in pediatric health centers across the United States. The case definition included six criteria: serious illness leading to hospitalization, an age of less than 21 years, fever that lasted for at least 24 hours, laboratory evidence of inflammation, multisystem organ involvement, and evidence of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) based on reverse-transcriptase polymerase chain reaction (RT-PCR), antibody testing, or exposure to persons with Covid-19 in the past month. Clinicians abstracted the data onto standardized forms.

RESULTS

We report on 186 patients with MIS-C in 26 states. The median age was 8.3 years, 115 patients (62%) were male, 135 (73%) had previously been healthy, 131 (70%) were positive for SARS-CoV-2 by RT-PCR or antibody testing, and 164 (88%) were hospitalized after April 16, 2020. Organ-system involvement included the gastrointestinal system in 171 patients (92%), cardiovascular in 149 (80%), hematologic in 142 (76%), mucocutaneous in 137 (74%), and respiratory in 131 (70%). The median duration of hospitalization was 7 days (interquartile range, 4 to 10); 148 patients (80%) received intensive care, 37 (20%) received mechanical ventilation, 90 (48%) received vasoactive support, and 4 (2%) died. Coronary-artery aneurysms (z scores ≥2.5) were documented in 15 patients (8%), and Kawasaki’s disease–like features were documented in 74 (40%). Most patients (171 [92%]) had elevations in at least four biomarkers indicating inflammation. The use of immunomodulating therapies was common: intravenous immune globulin was used in 144 (77%), glucocorticoids in 91 (49%), and interleukin-6 or 1RA inhibitors in 38 (20%).

CONCLUSIONS

Multisystem inflammatory syndrome in children associated with SARS-CoV-2 led to serious and life-threatening illness in previously healthy children and adolescents. (Funded by the Centers for Disease Control and Prevention.)

Author/s:

Feldstein, L.R., et al.

Persistent Value of the Stethoscope in the Age of COVID-19

Brian Desmarais — Mon, 22 Jun 2020 15:09:57 +0000

Date Added:

June 22, 2020

Journal/Publication:

The American Journal of Medicine

Publication Date:

June 19, 2020

URL:

Type:

Best Local Practices

Format:

Article

DOI (1):

https://doi.org/10.1016/j.amjmed.2020.05.018

Keywords

MeSH

Physician-Patient Relations

Physical Distancing, Face Masks, and Eye Protection to Prevent Person-To-Person Transmission of SARS-CoV-2 and COVID-19: A Systematic Review and Meta-Analysis

An interesting review of the history and future of the stethoscope including tips for disinfecting one. James W. Mold, MD, MPH

Free full text

View

Abstract

The stethoscope has long been at the center of patient care as well as a symbol of the physician-patient relationship. While advancements in other diagnostic modalities have allowed for more efficient and accurate diagnosis, the stethoscope has evolved in parallel to address the needs of the modern era of medicine. These advancements include sound visualization, ambient noise reduction/cancellation, Bluetooth™ transmission, and computer algorithm diagnostic support. However, despite these advancements, the ever-changing climate of infection prevention, especially in the wake of the COVID-19 pandemic, has led many to question the stethoscope as a vector for infectious diseases. Stethoscopes have been reported to harbor bacteria with contamination levels comparable to a physician's hand. Although disinfection is recommended, stethoscope hygiene compliance remains low. In addition, disinfectants may not be completely effective in eliminating microorganisms. Despite these risks, the growing technological integration with the stethoscope continues to make it a highly valuable tool. Rather than casting our valuable tool and symbol of medicine aside, we must create and implement an effective method of stethoscope hygiene to keep patients safe.

•Stethoscopes are clinically valuable and integral to the doctor-patient connection

•Technological advancement will augment the utility of the stethoscope

•The stethoscope has high utility for assessment of COVID-19 patients

•Pathogen contamination in light of COVID-19 is a concern for the stethoscope

•Innovations in stethoscope hygiene will allow safe auscultation

Author/s:

Vasudevan, R.S., Horiuchi, Y., Torianni, F.J., Cotter, B., Maisel, S.M., Dadwal, S.S., Gaynes, R., Maisel, A.S.

Physical Distancing, Face Masks, and Eye Protection to Prevent Person-To-Person Transmission of SARS-CoV-2 and COVID-19: A Systematic Review and Meta-Analysis

Brian Desmarais — Fri, 12 Jun 2020 19:24:31 +0000

Date Added:

June 12, 2020

Journal/Publication:

Lancet

Publication Date:

June 1, 2020

URL:

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1016/S0140-6736(20)31142-9

Keywords

face masks

social distancing

eye shields

MeSH

Severe Acute Respiratory Syndrome