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. COVID-19 and Coagulation: Bleeding and Thrombotic Manifestations of SARS-CoV-2 Infection

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      3. Coagulopathy associated with COVID-19 infection includes illness ranging from mild thrombocytopenia and rare prolongations of prothrombin time (PT) or partial thromboplastin time (PTT) resulting in increased risk for thrombosis and bleeding. D-dimer elevation at admission was found to be predictive of bleeding, thrombosis, critical illness and death among patients with COVID-19.
      4. Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic – United States, June 24–30, 2020

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      2. During this time period, adults in the U.S. reported elevated adverse mental health conditions associated with COVID-19. Overall, 40% of respondents reported at least one adverse mental or behavioral health condition. Those at greatest risk of mental health issues included: young adults, Hispanic and African Americans, essential workers, unpaid caregivers for adults, and those with preexisting psychiatric conditions.
      3. Low-Cost Measurement of Facemask Efficacy for Filtering Expelled Droplets During Speech

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      5. Theoretical data finds N95 masks most efficacious, followed by surgical masks, polypropylene masks, and handmade cotton face coverings. Gaiter-type fleece coverings converted larger respiratory droplets into numerous smaller droplets which can travel further and were considered “counterproductive.”
      6. Contact Settings and Risk for Transmission in 3410 Close Contacts of Patients with COVID-19 in Guangzhou, China

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    Household exposure to SARS-CoV-2 appears to be the most common risk factor for transmission based upon contact tracing, cell phone data, and public transportation use. 10% of household contacts to index cases became infected vs 1% from health care settings and 0.1% from public transportation. Risk for transmission increased as severity of index case symptoms increased.

    1. American Academy of Pediatrics Provides Guidance on Cloth Face Coverings, Coronavirus Testing, and PPE

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American Academy of Pediatrics (AAP) released guidance regarding children and COVID-19. This includes the recommendation for cloth face masks for nearly all children aged >/= 2 years and the recommendation to test children who have COVID-19 symptoms, a close contact with a confirmed case, and/or a scheduled elective procedure.

    1. Modeling the Onset of Symptoms of COVID-19

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Modeling data to discern influenza from COVID-19 found influenza initially presents as cough. COVID-19 often begins with fever, followed by URI symptoms, then upper GI symptoms, and finally lower GI symptoms.

    1. Extracorporeal Membrane Oxygenation for Patients with COVID-19 in Severe Respiratory Failure

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Venovenous extracorporeal membrane oxygenation (ECMO) has some potential for COVID-19 patients with severe respiratory failure despite receiving invasive mechanical ventilation.

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.