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(With inputs from Dr Monica Vasudev)
842: Most children hospitalized for COVID-19 had pre-existing conditions, with around 40% who needed invasive mechanical ventilation [study of U.S. and Canadian PICUs]
843: Gastrointestinal symptoms affected 26% of hospital employees hospitalized with presumptive COVID-19 infection, suggested the results of a study from Wuhan, China. Gastrointestinal symptoms most commonly included diarrhea (18%), nausea (8%), vomiting (6%), and abdominal pain (2%). [Zhou Z, et al. Gastroenterology. 2020 Mar 18.]
844: The successful treatment of a patient with pulmonary arterial hypertension who caught the COVID-19 infection with self-administered inhaled nitrous oxide from a tankless device at home has impressed researchers investigating treatments for other patients. [Medscape]
845: Initial research suggested that children are not as prone to severe COVID-19 as adults and those with co-morbidities. However, further studies pointed that children may be hit harder than previously thought. Since the guidelines have been telling us to look out for mainly three symptoms (a dry cough, fever and breathlessness), we might be missing COVID-19 in children, revealed a new study published in Frontiers in Pediatrics.
846: Digestive symptoms in children could point to coronavirus: GI symptoms such as diarrhea and an upset stomach might be the first clue of coronavirus infection. As per Dr Wenbin Li from the Department of Pediatrics at the Tongji Hospital in Wuhan, China, GI symptoms experienced by the children may be linked to the distribution of receptors and the transmission pathway associated with COVID-19 infection. The virus infects through the ACE2 receptor which is present in certain cells in the lungs as well as the intestines.
847: A study, published in the European Heart Journal, has noted higher plasma levels of the ACE2 receptor/enzyme in men compared to women in two large samples of patients with heart failure.
848: NEJM: There have been reports of transmission of SARS-CoV-2 from humans to domestic cats and to tigers and lions at the Bronx Zoo. Additionally there is data showing the ease of transmission between domestic cats. This necessitates a public health need to recognize and further investigate the potential chain of human–cat–human transmission. This is particularly important considering the potential for SARS-CoV-2 transmission between family members in households with cats while living under “shelter-in-place” orders. In 2016, an H7N2 influenza outbreak in New York City cat shelters highlighted the public health implications of cat-to-human transmission to workers in animal shelters. Cats may act as a silent intermediate host of SARS-CoV-2, as infected cats may not show any appreciable symptoms that might be recognized by the owners.
849: COVID-19 Supertreaters in the ICU - physicians who treat 20+ COVID-19 patients
850: Among Supertreaters in the ICU, 50% believe severe COVID-19 is more of a respiratory failure disease resulting in ARDS, necessitating ventilation support; 50% consider it is more of an oxygen failure disease necessitating oxygen therapy with ventilation as a last resort (n=118).
Dr KK Aggarwal
President CMAAO, HCFI, Past National President IMA, Chief Editor Medtalks