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COVID-19 Recap Part Five: Insights from Recent Noteworthy Articles

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Author: Frank Domino, MD in collaboration with Aylin Madore, MD

I stay up-to-date on the latest COVID-19 news and am regularly compiling a list of articles published that are relevant to your primary care practice. Read the insights below from recently published articles in less than two minutes.

      1. Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with Coronavirus Disease 2019 (COVID-19)

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      3. A multisystem inflammatory syndrome (MIS-C) related to COVID-19 and similar to Kawasaki’s disease (toxic shock syndrome) is reported in children. It is a “post-infectious immune response,” associated with a positive test either for SARS-CoV-2 or for antibodies to the virus.

      4. Proportion of Asymptomatic Coronavirus Disease 2019 (COVID-19): A Systematic Review and Meta-Analysis

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      2. A systematic review of 50,155 patients from 41 studies with confirmed COVID-19 found the rate of asymptomatic infection was 15.6% (95% CI: 10.1%-23.0%). The pediatric rate of asymptomatic infection was found to be 27.7% (95% CI: 16.4-42.7%), which is much higher than adult patients.

      3. Rates of Maternal and Perinatal Mortality and Vertical Transmission in Pregnancies Complicated by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-Co-V-2) Infection

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      5. A systematic review of pregnancy-related SAR-Co-V-2 infection found the risk of maternal intensive care unit admission was 3.0% (critical disease diagnosis (defined as respiratory failure, septic shock, and multiorgan dysfunction or failure) was 1.4%), with no deaths reported. The rate of preterm birth was 20.1% (~10%–11% in non-infected births worldwide); the cesarean section rate was 84.7% (almost triple the baseline rate in the 3 included countries). Vertical transmission did not occur; rates of neonatal death was found to be 0.3%.

      6. Association Between Statewide School Closure and COVID-19 Incidence and Mortality in the U.S.

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    National data on the rates of COVID-19 incidence and mortality across the U.S. after primary and secondary schools were closed in March 2020 found that school closures were associated with a 62% decline in the incidence of COVID-19 per week. The absolute reduction in COVID-19 incidence associated with school closures was estimated at 424 cases per 100,000 people during days 17–42 after closures. Regarding COVID-19-related mortality, school closures were associated with a decline of 58% per week after school closures. The absolute reduction was estimated at 13 deaths per 100,000 during days 27–42 after closures.

    1. Systematic Review on the Efficacy and Safety of Chloroquine/Hydroxychloroquine for COVID-19

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A Systematic Review of the use of hydroxychloroquine found the treatment of hospitalized COVID-19 patients with hydroxychloroquine did not reduce the risk of death or illness vs standard care. High dose regimens or when combined with macrolides may be associated with harm. Postexposure prophylaxis may not reduce the rate of infection but the quality of the evidence is low.

    1. Rapid Decay of Anti-SARS-CoV-2 Antibodies in Persons with Mild COVID-19

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A small U.S. study followed antibody levels after mild COVID-19 in 34 patients using serial anti–SARS-CoV-2 receptor binding domain IgG levels. The estimated mean IgG half-life was 36 days.

    1. Persistent Symptoms in Patients After Acute COVID-19

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Post-infection neuropsychiatric disorders were studied in a systematic review and meta-analysis from multiple countries. SARS-CoV-2 may cause delirium in the acute setting. Long term syndromes may include depression, anxiety, fatigue, PTSD, and rarer neuropsychiatric syndromes.

For more insights, view our collection of COVID-19 resources and CME courses. We recognize it is critical that you have access to timely, reliable information, so we are working hard to release new content in collaboration with our team of infectious disease experts, medical specialists, and primary care clinicians like Dr. Frank Domino.