COVID-19

First Cochrance review on antibody tests for SARS-CoV-2 infection covering 57 publications reporting by end of April 2020. Pooled results for IgG, IgM, IgA, total antibodies and IgG/IgM all showed low sensitivity during the first week since onset of symptoms (all less than 30.1%), rising in the second week and reaching their highest values in the third week.

Two cohorts of soldiers from the Swiss army were compared. The rate of clinically apparent infected soldiers was reduced from 30% to zero after implementation of social distancing.

Description of 95 patients with Multisystem Inflammatory Syndrome in Children (MIS-C or PIMS) demonstrating that the freuency of clinical myocarditis (defined as cardiac dysfunction on echochardiography PLUS elevated troponin) increases with age, affecting 73% of adolescents with MIS-C.

This is the first large European cohort of pediatric SARS-CoV-2 cases. Its findings are consistent with previous data from China indicating that COVID-19 in predominantly hospitalized patients is generally mild.

Erste Resultate dieser in England durchgeführten grossen, randomisierten, kontrollierten Studie waren bereits durch Pressemitteilungen Mitte Juni durchgesickert. Die ausführlichen Resultate liegen nun als Preprint-Publikation vor.

An Italian study in 28 patients presenting with ST-elevation myocardial infarction (STEMI), who were test positive for COVID-19 and who underwent coronary angiography showed in only 61% an atherosclerotic stenosis. The research team was unable to determine in the remaining patients whether STEMI in this group was due to type 2 myocardial infarction, myocarditis, infection-related endothelial dysfunction, or a cytokine storm. The authors conclude, that the majority of patients without obstructive coronary artery indicate that COVID-19 can mimic a STEMI without a coronary artery actually occluding, which must be considered during treatment. However, due to the very small number of patients, the significance of the study is limited and that the results should be confirmed by further larger studies.

Pregnant women and their fetuses represent a high-risk population during COVID-19 disease outbreaks. To date, the outcomes of 55 pregnant women infected with COVID-19 and 46 neonates have been reported in the literature, with no definite evidence of vertical transmission. This paper represents a review of COVID-19 in pregnancy, bringing together the various factors integral to the understanding of pathophysiology and susceptibility, diagnostic challenges with real-time reverse transcription polymerase chain reaction (RT-PCR) assays, therapeutic controversies, intrauterine transmission, and maternal-fetal complications.

The potential for exposure to SARS-CoV-2 through breastfeeding is currently unknown. This study reported that although SARS-CoV-2 RNA was detected in one milk sample from one of eighteen infected women, the viral culture for that sample was negative. This suggests that SARS-CoV-2 RNA does not represent replication-competent virus and that breastmilk itself is likely not a source of infection for the infant. Furthermore, when control breastmilk samples spiked with replication-competent SARS-CoV-2 virus were treated by Holder pasteurization, a process commonly performed by donor milk banks, no replication-competent virus nor viral RNA was detectable. These findings suggest that pasteurized donor milk is safe.

Case series of patients with abdominal pain as presenting symptom of CAVID-19

Swabs were obtained from the surgical field in the abdomen in patients with symptomatic COVID-19. SARS-Cov-2 was detected only in the feces and the duodenal wall in a patient with perforated peptic ulcer. All other tissues and fluds were negative.