🦘Cacatman's Personal Coronavirus COVID-19 Update Thread

[cacatman]

Everything you wanted to know about masks/faceshields

A Visual Guide to Face Masks: What Works, What Doesn't

The latest data on the best and worst of the face masks in the fight against COVID-19, and a glimpse into what future face masks might look like.

www.medscape.com

 

[cacatman]

Transmission rates from Chinese studies
Showed greater severity of index-case illness resulted in greater risk for transmission, which ranged from 0.3% in contacts of asymptomatic cases to 6.2% in contacts of severe/critical cases.

NEJM Journal Watch: Summaries of and commentary on original medical and scientific articles from key medical journals

NEJM Journal Watch reviews over 250 scientific and medical journals to present important clinical research findings and insightful commentary

www.jwatch.org

 

[cacatman]

Restaurant Dining Information
Bottom Line - Avoid restaurants/cafes (even after they reopen) (Ed note - Risk presumably is because you are unmasked).
- If you must meet people, try to do it OUTSIDE!

Details
Restaurants/cafes/bars are strongly associated with COVID positivity. Close contact with persons with known COVID-19 or going to locations that offer on-site eating and drinking options were associated with COVID-19 positivity.

Adults with positive SARS-CoV-2 test results were approximately twice as likely to have reported dining at a restaurant than were those with negative SARS-CoV-2 test results.

Being indoors is 18.7 times more risky for you (95% confidence interval) compared to being in an open-air environment.

Community and Close Contact Exposures Associated with COVID-19 ...

Community and close contact exposures continue to drive the coronavirus disease 2019 (COVID-19) pandemic. CDC and other public health authorities recommend community mitigation strategies ...

www.cdc.gov

Closed environments facilitate secondary transmission of coronavirus disease 2019 (COVID-19)

Objective To identify common features of cases with novel coronavirus disease (COVID-19) so as to better understand what factors promote secondary transmission including superspreading events. Methods A total of 110 cases were examined among eleven clusters and sporadic cases, and investigated...

www.medrxiv.org

“Eating indoors at a restaurant is one of the riskiest things you can do in a pandemic,” she said. “Even if there is distancing, as this shows and other studies show, the distancing is not enough.”

Evidence of Long-Distance Droplet Transmission of SARS-CoV-2 by Direct Air Flow in a Restaurant in Korea

Kwon KS, et al. J Korean Med Sci. 2020 Nov;35(46):e415. https://doi.org/10.3346/jkms.2020.35.e415

jkms.org

COVID-19 Outbreak Associated with Air Conditioning in Restaurant, Guangzhou, China, 2020

During January 26–February 10, 2020, an outbreak of 2019 novel coronavirus disease in an air-conditioned restaurant in Guangzhou, China, involved 3 fa...

wwwnc.cdc.gov

 

[cacatman]

Reinfection Possible
25 yo from Nevada. Mid April - After 10 days, symptoms went away, then tested negative twice, then reinfected in May. Hospitalised the second time. Genetic testing showed different RNA although both were COVID-19.

Scientists are reporting several cases of Covid-19 reinfection — but the implications are complicated

There are now several documented cases of people becoming reinfected with Covid-19. But experts stress that’s not cause for panic. Here’s how to interpret the news.

www.statnews.com

 

[cacatman]

Oxford Astrazeneca Vaccine
Taking a chimp adenovirus and getting it to present the spike protein from COVID-19 so that Antibodies are made against the spike protein

New study reveals Oxford coronavirus vaccine produces strong immune response — Oxford Vaccine Group

A team of scientists at Oxford Vaccine Group (Department of Paediatrics) and Oxford University’s Jenner Institute has taken the next step towards the discovery of a safe, effective and accessible vaccine against coronavirus.

www.ovg.ox.ac.uk

Corneal "Melting"
The patient was a 48-year-old man who presented to the ophthalmic emergency department with what was described as progressive bilateral corneal melting 5 weeks after he received the first dose of the COVID-19 vaccine.

“Immune-mediated keratolysis after the ChAdOx1 nCoV-19 (Covishield) vaccination is a rare entity, and we believe that this is the first report of a temporal association between a serious ocular adverse event after a single dose of any SARS-CoV-19 vaccine,” investigators concluded. “It may be included as a possible adverse event associated with this vaccine.”

COVID-19 vaccine may be linked to bilateral cornea melting | Ophthalmology Times - Clinical Insights for Eye Specialists

A 48-year-old male patient presented to an ophthalmic emergency department with what was described as progressive bilateral corneal melting 5 weeks after he received the first dose of a COVID-19 vaccine.

www.ophthalmologytimes.com

 

[cacatman]

Treatment - N-acetyl cysteine
May have a role in being an anti-mucolytic, but also in helping reduce clots generally. anecdotal evidence 600 mg 2x/day. Similar to the dose in the 1998 study with influenza.
Symptoms were decreased over 6 months from 75%->25%

Attenuation of influenza-like symptomatology and improvement of cell-mediated immunity with long-term N-acetylcysteine treatment - PubMed

N-acetylcysteine (NAC), an analogue and precursor of reduced glutathione, has been in clinical use for more than 30 yrs as a mucolytic drug. It has also been proposed for and/or used in the therapy and/or prevention of several respiratory diseases and of diseases involving an oxidative stress...

pubmed.ncbi.nlm.nih.gov

135 patients severe COVID-19 with Sa02 <94%
21 gm for 20 hours
randomised
Results - Slightly less people were intubated 23.9% vs 20.6%. Not significant.

Double-blind, randomized, placebo-controlled trial with N-acetylcysteine for treatment of severe acute respiratory syndrome caused by COVID-19 (Clinical Infectious Diseases) | Double-blind, Randomized, Placebo-controlled Trial With N-acetylcysteine for Treatment of Severe Acute Respiratory Syndrome Caused by Coronavirus Disease 2019 (COVID-19)

Study in the 1990s - Patients taking 600mg BD didn't get less flu infections during the flu season, but they got through with less symptoms. Could still work in the early setting.

N-acetylcysteine: A rapid review of the evidence for effectiveness in treating COVID-19 | The Centre for Evidence-Based Medicine

www.cebm.net

 

[cacatman]

40% of all Infected People are Asymptomatic
T cells investigated in 2 populations :-
1. post covid patients - Found 100% reactivity in T-cells
2. Pre COVID (2015-2018) patients - 40-60% T cell recognition of COVID-19!! Probably due to coronavirus infections previously. ie. pre-existing pre existing immunity.

Clinical and immunological assessment of asymptomatic SARS-CoV-2 infections - Nature Medicine

A cohort of asymptomatic patients infected with SARS-CoV-2 had significantly lower levels of virus-specific IgG antibodies compared to a cohort of age- and sex-matched symptomatic infected patients.

www.nature.com

Masks Do More Than Protect Others During COVID-19: Reducing the Inoculum of SARS-CoV-2 to Protect the Wearer

Although the benefit of population-level public facial masking to protect others during the COVID-19 pandemic has received a great deal of attention, we discuss for one of the first times the hypothesis that universal masking reduces the “inoculum” or dose of the virus for the mask-wearer...

link.springer.com

 

[cacatman]

Massive Indian Study Showed 8% of Primary Contacts Spread to 60%
Indian study contact tracing of > 575,000 people exposed to 85,000 cases March-> August showed that just 8% of the primary cases were responsible for 60% of the contacts that were infected. Most of these spreaders were aged between 20-45 y.o. 70% of infected were found not to infect any of the contacts.

AAAS

science.sciencemag.org

 

[cacatman]

Immunothrombosis in COVID-19
Covid produces proteins that triggers an inflammatory response in the body by clumping together. This stresses the endoplasmic reticulum and triggers an immune response which can cause acute respiratory distress syndrome, a hyper inflammation syndrome which can be helped by administering dexamethasone in oxygen dependent patients. A drug called 4-PBA can prevent ER stress by stopping the clumping that occurs when proteins clog up the ER.

Should we unstress SARS-CoV-2 infected cells?

www.sciencedirect.com

In patients hospitalized with Covid-19, the use of dexamethasone resulted in lower 28-day mortality among those who were receiving either invasive mechanical ventilation or oxygen alone at randomization but not among those receiving no respiratory support.

https://www.nejm.org/doi/full/10.1056/NEJMoa2021436

 

[cacatman]

Bathrooms/Toilets SUPER RISKY!!!
In a study comparing three hand-drying methods (paper towels, warm air dryers and jet air dryers at ultrahigh speeds), scientists found that jet dryers dispersed 20 times more virus than the warm air dryer and over 190 times more than paper towels, and that the impact of the virus was greatest at 2½ feet to 4.1 feet — which is about where a small child would be standing. In a separate study, scientists found that petri dishes exposed to bathroom air hand dryers grew significantly more colonies of bacteria. Without hand dryers on, the petri dishes had less than one colony of bacteria; with 30 seconds of hand dryers on, the petri dishes had an average of 18 to 60 colonies, one even as high as 254.

Evaluation of the potential for virus dispersal during hand drying: a comparison of three methods - PubMed

The choice of hand-drying device should be considered carefully in areas where infection prevention concerns are paramount, such as healthcare settings and the food industry.

pubmed.ncbi.nlm.nih.gov

Deposition of Bacteria and Bacterial Spores by Bathroom Hot-Air Hand Dryers

Hot-air hand dryers in multiple men's and women's bathrooms in three basic science research areas in an academic health center were screened for their deposition on plates of (i) total bacteria, some of which were identified, and (ii) a kanamycin-resistant Bacillus subtilis strain, PS533, spores...

aem.asm.org

...and while I'm at it, "toilet plume" from flushing toilets is a thing. If you flush with the toilet open, it sends plumes up to 15 feet into the air!!!

PRIME PubMed | Lifting the lid on toilet plume aerosol: a literature review with suggestions for future research

The potential risks associated with "toilet plume" aerosols produced by flush toilets is a subject of continuing study. This review examines the evidence regarding toilet plume bioaerosol generation and infectious disease transmission.

www.unboundmedicine.com

https://aip.scitation.org/doi/10.1063/5.0013318

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC187159/pdf/applmicro00026-0083.pdf

Toilets May Pose Risk for Spreading COVID-19

Dr David Johnson on the reasons why toilets may be one source of this mysterious disease's spread.

www.medscape.com