COVID-19 research briefs by Essential Evidence Plus (EE+)

COVID-19 research briefs by Essential Evidence Plus (EE+)

As the COVID-19 pandemic continues to evolve, the Joule team is working closely with Dr. Mark Ebell, Editor-in-Chief of EE+ and the team at Wiley Publishing to share current research summaries with physicians.

POEMs* subscribers will receive COVID-19 related research briefs on most weekends and on select weekdays. You can view these updates below, subscribe to receive daily POEMS, refer to the POEMs archive (cma.ca login required) to comment on these summaries or collect CPD credits, or refer to the Essential Evidence Plus COVID-19 website.

Essential Evidence Plus (EE+) is making relevant COVID-19 information freely available, to help physicians caring for patients around the world. Topic updates on Coronavirus SARS-CoV2 infection (COVID-19) are being made as new information becomes available.

Clinical Question

What is the rate of COVID-19 among asymptomatic pregnant women? Can homemade face masks prevent transmission of the virus?

Bottom line

The high rate of asymptomatic carriage of COVID-19 among pregnant women admitted to hospitals in New York suggests that COVID-19 spread will be difficult to contain with medical isolation, quarantine, and contact tracing only. There is equivocal evidence of effectiveness of face masks for preventing transmission. 4

Author(s)

John Hickner, MD, MS

Clinical Question

What was the outcome for patients hospitalized with COVID-19 in New York City in March/April 2020? Can a cluster of COVID-19 cases be linked to a small restaurant in China, despite table distancing?

Bottom line

COVID-19 infection had a high mortality rate in patients who were hospitalized in New York City during March/April 2020, especially in those who required mechanical ventilation. Investigators uncover possible transmission of COVID-19 in a restaurant in China despite a distance of 1 meter (3 feet) among tables. 4

Author(s)

John Hickner, MD, MS

Clinical Question

Does SARS-CoV-2 infection increase the risk of stroke in people younger than 50 years? Can remdesivir improve recovery time in people with SARS-CoV-2 infection?

Bottom line

This very small case series indicates that COVID-19 may increase the rate of stroke in people younger than 50 years. Preliminary data from this large US trial shows shorter recovery tiime in people who received remdesivir 4

Author(s)

Mark H. Ebell, MD, MS

Clinical Question

What were the outcomes for patients infected with COVID-19 in Wuhan, China, in January 2020? What are the current Infectious Disease Society of America treatment guidelines for patients with COVID-19?

Bottom line

This retrospective cohort study of 191 adults hospitalized in Wuhan, China, with confirmed COVID-19 infections who had been discharged or had died by January 31, 2020, reports that 72% were discharged and 28% died as inpatients. The Infectious Disease Society of America (IDSA) guidelines recommend specific agents in the context of a clinical trial (hydroxychloroquine or chloroquine, hydroxychloroquine/chloroquine plus azithromycin, lopinavir/ritonavir) and recommend tailoring use/non-use of corticosteroids in specific populations. 4

Author(s)

Henry C. Barry, MD, MS

Clinical Question

What is the incidence of anosmia in patients with COVID-19? Can hydroxychloroquine with or without azithromycin improve outcomes in patients hospitalized with the virus?

Bottom line

Although the loss of the sense of smell is a feature of sinus infections, the rate of anosmia appears to be higher in patients with COVID-19 than would ordinarily be the case with other viral respiratory infections. Retrospective data suggest no benefit of hydroxychloroquine with or without azithromycin in patients in US Veterans Health Administration medical centers. 4

Author(s)

Mark H. Ebell, MD, MS

Clinical Question

How common is the presymptomatic transmission of the COVID-19 virus?

Bottom line

This analysis of the temporal pattern of viral shedding of COVID-19 finds that a high proportion of secondary cases were infected when the index case was presymptomatic. 4

Author(s)

Henry C. Barry, MD, MS

Clinical Question

Can speaking through a damp washcloth reduce the number of the aerosolized droplets that have been implicated in the transmission of the COVID-19 virus?

Bottom line

Speaking through a damp washcloth resulted in a reduction of the droplets generated by speech. These droplets have been implicated as a possible source of transmitting the COVID-19 virus. It is unclear, however, whether the use of a damp washcloth could reduce the viral transmission of COVID-19. 5

Author(s)

Henry C. Barry, MD, MS

Clinical Question

How can telehealth best be used to manage patients during quarantine for COVID-19?

Bottom line

Providing telehealth services is essential for managing the unprecedented COVID-19 pandemic. See the synopsis for useful tools and protocols that support clinicians. 5

Author(s)

Henry C. Barry, MD, MS

Clinical Question

Can remdesivir improve outcomes in patients with COVID-19?

Bottom line

This uncontrolled case series of 53 patients with COVID-19 shows early promise for remdesvir, but further evidence from randomized controlled trials is needed. 4

Author(s)

Mark H. Ebell, MD, MS

 

 

*DisclaimerPOEMs stands for Patient-Oriented Evidence that Matters. POEMs is a publication of John Wiley and Sons, Inc. and distributed by Joule as a CMA Member service. All content is provided for information and education and not as a substitute for the advice of a physician. Joule assumes no responsibility or liability arising from any error or omission or from the use of any information contained herein.