With input from Dr Monica Vasudev

1155: First Rapid At-Home COVID Test: The US FDA has issued an EUA for the first at-home COVID-19 test, which provides results within 30 minutes. The All-In-One Test Kit is a molecular, single-use test that detects SARS-CoV-2 with the help of self-collected nasal swab samples among people aged 14 years and older. The test has also been authorized for use in doctors offices, hospitals, urgent care centers, and emergency departments for patients of all ages. The samples need to be collected by a healthcare provider when the test is used in these care settings for patients below 14 years of age.

The test kit comprises of the test device, sample vial, swab, and instructions. Two AA batteries are inserted in the device, and the sample vial is then placed in the test unit. The user then opens the test swab packet and rotates the swab in each nostril five times. This is followed by stirring the swab in the sample vial and pressing it down in the test unit to start the test. The "ready" light then blinks. Within 30 minutes, a "positive" or "negative" green light is illuminated.

In a community sample, the test reached a 94% positive percent agreement and a 98% negative percent agreement. Excluding samples with very low levels of virus that possibly no longer reflected active infection, this test achieved 100% positive percent agreement. The test is expected to cost around $50.

[Medscape]

1156:  Obese younger people at greater risk for severe COVID-19: Obese people aged 50 years and below have greater odds of being hospitalized with COVID-19 and are at higher risk of in-hospital death or mechanical ventilation, reported a study published in Circulation. [DG Alerts]

1157: Mortality reduction contributing factors

1. Mortality rate in the U.S. has fallen since the start of the pandemic.  Contributing factors include a greater proportion of cases among the younger population, increased knowledge of how to treat, better therapies, and less overcrowding in hospitals.
2. From June through August, 20- to 29-year-olds were found to have the highest incidence of COVID-19, thus showing a shift from the start of the pandemic, when older adults saw the highest number of infections. As per the CDC, the median age of infected patients declined from 46 in May to 38 in August.
3. A preprint in medRxiv revealed that the age-specific infection fatality rate was low among children and young adults, measuring 0.002% at age 10 and 0.1% at age 25. The rate exhibited a progressive increase with age, going from 0.4% at age 55 to around 15% at age 85.
4. In a cohort of over 5,000 hospitalized COVID-19 patients at NYU, mortality rates declined 18 percentage points from the start of the pandemic, coming down from 26% in March to 8% in August. Even after adjusting for age differences, a considerable reduction in COVID deaths was evident.
5. Early-intubation was used early in the pandemic for patients with low oxygen levels. However, proning appears to play a key role in COVID-19 care.
6. Dexamethasone greatly reduced deaths by a third in patients on mechanical ventilation, and by a fifth among those on supplemental oxygen.
7. Jeremy Faust, MD, an emergency physician at Brigham and Womens Hospital in Boston, and colleagues wrote a medRxiv preprint study which suggested that COVID-19 was likely the leading cause of death in people aged 25 to 44.

[Medpage Today]

Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA