Thursday, May 14, 2020

CMAAO IMA CORONA FACTS and MYTH BUSTER 94


CMAAO IMA CORONA FACTS and MYTH BUSTER 94

Dr K K Aggarwal
President Confederation of Medical Associations of Asia and Oceania, HCFI, Past National President IMA, Chief Editor Medtalks

With inputs from Dr Monica Vasudev

New facts


842: Most children hospitalized for COVID-19 had pre-existing conditions, with nearly 40% who required invasive mechanical ventilation [U.S. and Canadian PICU]

843:  Gastrointestinal symptoms affected 26% of hospital employees hospitalized with presumptive COVID-19 infection, according to the results of a study from Wuhan, China. Most commonly included diarrhea (18%), nausea (8%), vomiting (6%), and abdominal pain (2%), the researchers reported. [ Zhou Z et al. Gastroenterology. 2020 Mar 18.]

844: The successful treatment of a patient with pulmonary arterial hypertension who contracted COVID-19 with self-administered inhaled nitrous oxide from a tankless device at home has caught the imagination of researchers investigating treatments for other patients.

845: While initial research suggested that children are not as susceptible to severe Covid-19 as adults and those with co-morbidities, further studies indicated that children may be hit harder by Covid-19 than initially thought. Because of guidelines telling us to look out for mainly three symptoms (a dry cough, fever and breathlessness), we might be missing Covid-19 in children, according to a new study published in Frontiers in Pediatric

846: Digestive symptoms in children can be a sign of coronavirus: GI symptoms such as diarrhoea and an upset stomach might be the first hints of coronavirus infection. As per Dr Wenbin Li from the Department of Pediatrics at the Tongji Hospital in Wuhan, China, ACE2 receptor, which can be found in certain cells in the lungs as well as the intestines.

847: One study, published in the European Heart Journal, found higher plasma levels of the ACE2 receptor/enzyme in men vs women in two large samples of patients with heart failure.

848: NEJM: With reports of transmission of SARS-CoV-2 from humans to domestic cats and to tigers and lions at the Bronx Zoo, coupled with our data showing the ease of transmission between domestic cats, there is a public health need to recognize and further investigate the potential chain of human–cat–human transmission. This is of particular importance given 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 shelters5 highlighted the public health implications of cat-to-human transmission to workers in animal shelters. Moreover, cats may be a silent intermediate host of SARS-CoV-2, because infected cats may not show any appreciable symptoms that might be recognized by their 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 and necessitating ventilation support; 50% believe it is more of an “oxygen failure” disease necessitating oxygen therapy with ventilation as a last resort (n=118).  

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