COVID-19

In this overview, the authors discuss the uncertain effects of RAAS inhibitors on ACE2 in humans and as well the potential for benefit rather than harm of RAAS inhibitors in Covid-19 patients.

This study analysed the CT images of 112 COVID-positive passengers on the cruise ship Diamond Princess. CT revealed abnormal findings in keeping with COIVD-19 pneumonia in 44 (>50%) of the 82/112 asymptomatic patients. Among the 30/112 symptomatic patients CT was abnormal in 80% (24/30) but normal in 20% (6/30) cases.

In this “Consensus Statement on Reporting of CT Findings Related to COVID-19”, the Radiological Society of North America (RSNA) offers aids in recognizing, reporting, and communicating CT imaging findings of COVID-19 pneumonia to facilitate the management and care of patients.

Currently the largest case series of pediatric patients reported from China, with 713 virologically confirmed and 1412 supected cases, respectively. 13% of patients were asymptomatic, 84% had mild to moderate disease, 3% had "severe" disease as defined by supplemental O2 requirement. There were no fatal cases.

199 hospitalized individuals in China with laboratory-confirmed COVID-19 infection and signs of respiratory impairment were randomized (1:1) to receive LPV/r for 14 days or standard of care alone. No difference in time to clinical improvement or mortality was found between the 2 groupes.

In a nationwide analysis of 1590 hospitalized patients with laboratory-confirmed COVID-19 infection across China, the number of comorbidities (mainly hypertension , diabetes and malignancy) was associated with the composite primary endpoint (admission to intensive care unit, or invasive ventilation, or death). The HR was 1.79 (95%CI 1.16-2.77) among patients with at least one comorbidity and 2.59 (95%CI 1.61-4.17) among patients with two or more comorbidities.

The majority of hospitalized children <16 years (168 of 171; 98%) at Wuhan Children's Hospital (90% identified in family clusters) presented with mild or asymptomatic disease. Fever, cough, pharyngeal erythema in roughly 45% of cases, but chest CT with evidence of pneumonia in 65%.

For COVID-19 patients with diabetes, tailored therapeutic strategies and optimal glucose control should be formulated. Blood glucose should be controlled for all patients during hospitalization to monitor the progress of illness and avoid aggravation. During the follow-up period after discharge, blood glucose homeostasis should be maintained continuously. The popularization of Internet and smartphones ensure remote medical consultation for patients who are not advised to go to the hospital.

Data on parturient patients with COVID-19 is scarce and is limited to case reports. COVID-19 patients may have a higher risk for respiratory compromise and viral meningitis/encephalitis. This review and expert opinion concludes that neuraxial anesthesia is still the safest anaesthesia form for most patients despite these circumstances. However, anaesthesiologists should be aware of potential lower platelet counts.

False negative test results: In a cohort with COVID-19 and available CT and blood results, initial test results for SARS-CoV-2 were negative in 52.2%.