« previous next » Print Pages: 1 Go Down Author Topic: Quick summary of covid literature so far by two HIV clinical fellows at Boston (Read 12604 times) stog Administrator Full Member Posts: 211 Quick summary of covid literature so far by two HIV clinical fellows at Boston « on: June 05, 2020, 09:13:38 AM » a Quick summary of covid literature so far by two HIV clinical fellows at Boston hospitals have recorded a biweekly deep dive into the most compelling COVID-19 data. this is snapshot as at may 18 2020 this is page 3 so there is more -- move left at bottom of pagehttps://www.medscape.com/viewarticle/930588#vp_3 Report to moderator Logged stog Administrator Full Member Posts: 211 Re: Quick summary of covid literature so far by two HIV clinical fellows at Boston « Reply #1 on: June 05, 2020, 09:17:01 AM » Here are some key points from our first three presentations that are still valid.Viral Shedding: Key PointsNasopharyngeal viral load peaks around 1 day prior to symptom onset, correlating to peak time of infectiousness.Saliva may become an important sampling site for diagnosis.SARS-CoV-2 is a descending infection; in later disease, viral loads are higher in the lower respiratory tract (especially in severe/critical illness).In mild cases, live virus is isolated up to day 8 after symptom onset.There can be prolonged shedding of viral RNA lasting many weeks, particularly after critical illness. Correlation with infectiousness is unknown.Studies differ on whether severity of illness correlates with viral load.In some cases, viral RNA has also been identified in the stool, blood, conjunctiva, urine, cerebrospinal fluid, and pleural fluid.SARS-CoV-2 SeroprevalenceStudies with (near) universal screening of various populations are increasingly available, finding a wide range of asymptomatic people with positive RT-PCR tests. Pregnant women in NYC: 13.5% (87% of total infections) Homeless shelter in Boston: 36% (great majority of infections) Town in Italy: < 1% (41% of total infections) Iceland: < 1% (43% of total infections) Diamond Princess cruise ship: 9% (46% of total infections) Varying rates relate to local stage of epidemic, population and sampling, and mitigation strategies in place.Some asymptomatic people are likely to be presymptomatic given the variable and sometimes lengthy incubation period.Viral Entry: Key PointsACE2 is an important receptor for viral cellular entry.TMPRSS2 primes the S protein and allows for efficient cellular entry.An interaction between SARS-CoV-2 and CD147 may facilitate invasion.Many unresolved questions remain regarding the exact role of CD147 in viral entry. Does it directly interact with the S protein or is the interaction mediated by CypA and the N protein, as was found for SARS-CoV?What Else Have We Learned?Key observations from our first three updates that are still relevant:Peak infectiousness is probably 1 day prior to symptom onset.In the absence of therapy/vaccine, intermittent social distancing is likely to be needed for years to avoid overwhelming critical care capacity.Emerging pathologic correlates of clinical presentations: Multiple mechanisms of cardiac injuryVirus can cause systemic infectionViral endotheliitis and possible complement activation as cause of micro/macro thromboses Obesity is a risk factor for severity of disease.Hypercoagulability is a key feature of the disease.Age-based sheltering is unlikely to be effective without social distancing.Epidemic control is feasible with contact tracing if minimal delay is achieved.Asymptomatic/presymptomatic transmission is substantial.The incubation period is highly variable (median, 5 days). « Last Edit: June 05, 2020, 09:22:37 AM by stog » Report to moderator Logged stog Administrator Full Member Posts: 211 Re: Quick summary of covid literature so far by two HIV clinical fellows at Boston « Reply #2 on: June 05, 2020, 09:22:04 AM » here is the table key findings in mode of transport, and the clinical course all taken from the summary link in main post Report to moderator Logged Print Pages: 1 Go Up « previous next » Tags: summary of literature so far summary viral shedding seroprevalence viral entry mode of transport the clinical course C19 Notes / General Category / C19 Notes Database / Quick summary of covid literature so far by two HIV clinical fellows at Boston