COVID-19 Journal Club

Study objectives: The authors aimed to estimate the false-negative rate of the SARS-CoV-2 RT-PCR by days since infection. Methods and Results: Data from seven previously published studies on reverse transcriptase polymerase chain reaction (RT-PCR) performance by time since symptom onset were included in a pooled analysis. The studies included a...
Study objectives: Research letter to determine if the Bacillus Calmette–Guérin (BCG) vaccine administered in childhood for tuberculosis reduces the rate of COVID-19 infections. Methods and Results: The BCG vaccine was routinely administered to all newborns in Israel between 1955 and 1982 with high acceptability and coverage amongst citizens. Since 1982...
Background: Protocolized prone positioning has been shown to decrease mortality in patients with severe ARDS requiring mechanical ventilation [2]. Patients with COVID-19 can develop severe hypoxemic respiratory failure, with recent physiologic and autopsy studies showing similar pathophysiology to ARDS [3,4]. Methods: Single-center prospective before-after study of prone positioning in nonintubated...
Purpose: A study to investigate the relationship between underlying cardiovascular disease and COVID-19 outcomes in addition to evaluating the association between cardiovascular drug therapy and mortality in patients with COVID-19. Study Design: Observational study using de-identified data from the Surgical Outcomes Collaborative international registry from 169 hospitals in Asia, Europe...
Background: Remdesivir is a nucleoside analogue prodrug that has been shown to inhibit human and animal coronaviruses in animal models, and SARS-CoV-2 in vitro. Methods: Randomized, double-blind, placebo-controlled trial in 10 hospitals in Hubei, China [1]. Patients with lab confirmed COVID-19 pneumonia with 12 days or fewer of symptoms were...
Two recent papers published in the New England Journal of Medicine sought to rigorously study the relationship between COVID-19 and antihypertensive medications that impact the renin-angiotensin-aldosterone system (RAAS), including Angiotensin Converting Enzyme (ACE) inhibitors and Angiotensin Receptor Blockers (ARBs). A link has been suggested on the basis that SARS-CoV-2 enters...
Purpose: Research letter to describe the characteristics of hospitalized adults with COVID-19 from Kaiser Permanente Northern California (KPNC). Study Design: Retrospective cohort study of adults >18 years with nasal/throat swabs (+) for SARS-CoV-2 by RT-PCR between March 1st–March 31st at 21 KNPC hospitals. Patients were triaged by clinician judgement and...
Background: The “cytokine storm” or hyper-inflammatory state of some patients with COVID-19 has been reported since the early days of the pandemic. Mediators of this inflammatory state include IL-2, IL-6, IL-7, IL-12, TNF-α, and IL-1β, among others. Pharmacologic blockade of these inflammatory pathways has been postulated as a possible treatment...
Background: The principle symptoms of COVID-19 are fever, cough, dyspnea, fatigue, and myalgia, however anecdotal reports of anosmia (loss of sense of smell) began circulating on social media, and previous strains of coronavirus have been demonstrated to invade the CNS and olfactory bulb. Methods: Single-center study in an Italian hospital...
Overview There should be continual communication with state and local authorities to determine current mitigation levels in community. There are recommended steps for each phase of the process: Phase 1: for states and regions that satisfy the gating criteria Phase 2: for states and regions with no evidence of a...