Why We’re Losing the Battle With Covid-19 – New York Times

Editor’s Note: Just listened to this excellent article while working on this edition. Highly recommend.

The escalating crisis in Texas shows how the chronic underfunding of public health has put America on track for the worst coronavirus response in the developed world. [If link above does not work, try this]

Immune Response Varied Among COVID-19 Patients – Med Page Today

Small study finds wide range, with implications for vaccine development [Related Study in Nature]

Study in Primates Finds Acquired Immunity Prevents COVID-19 Reinfections – NIH Director’s Blog

There have been rare reports of people recovering from infection with SARS-CoV-2, the novel coronavirus that causes COVID-19, only to test positive a second time. Such results might be explained by reports that the virus can linger in our systems. Yet some important questions remain: Is it possible that people could beat this virus only to get reinfected a short time later? How long does immunity last after infection? And what can we expect about the duration of protection from a vaccine? [Related Study]

We could have more coronavirus outbreaks in tower blocks. Here’s how lockdown should work

The recent lockdown of nine social housing towers in Melbourne’s north to contain the spread of COVID-19 led to widespread concerns for residents’ welfare. Among the concerns was that implementation of these lockdowns was less than perfect in terms of infection control. In housing commission towers, many people live in close quarters and share facilities, making them a high-risk setting for outbreaks of infectious disease.

This Tennessee doctor caught coronavirus at a meeting about coronavirus. He nearly died – USA Today

It was mid-March when Dr. Daniel Lewis, the chief medical officer at a Tennessee hospital, attended a small meeting about how to keep the coronavirus from spreading within the medical center.

Winter wave of coronavirus ‘could be worse than first’ – BBC

Asked to model a “reasonable” worst-case scenario, they suggest a range between 24,500 and 251,000 of virus-related deaths in hospitals alone, peaking in January and February.

Clinical Considerations

Babies’ Mysterious Resilience to Coronavirus Intrigues Scientists – Scientific American

COVID-19 is often mild in infants. Learning why could help scientists better understand the disease—and point the way toward possible treatments [CDC Study] [another study]

SARS-CoV-2 Linked to Brain Lesions in Non-Survivors of COVID-19 – Neurology Advisor

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may induce hemorrhagic and encephalopathy-related brain lesions in patients who died from the coronavirus disease 2019 (COVID-19), according to findings from a postmortem brain magnetic resonance imaging (MRI) study published in Neurology.

Study Shows SARS-CoV-2 Can Directly Attack Heart Cells and Change Their Function – BioMedAdvances

Infection with SARS-CoV-2, the virus that causes COVID-19, can produce a wide range of symptoms. Some patients experience heart complications with COVID-19 such as a change in heart rhythm. Some patients have suffered damage to the heart cells which has led to heart attacks, while others have experienced circulatory system changes which have led to blood clots forming.

New study shows SARS-CoV-2 viral load peaks in the early stages of disease – Medical Express

In a retrospective study, investigators from New York University Langone Health found that the quantity of SARS-CoV-2 (viral load) collected from patients in the emergency department is significantly higher in patients with fewer or milder symptoms who did not require hospitalization—the opposite of what might be expected. Reporting in The American Journal of Pathology, published by Elsevier, they also found that a patient’s history of cancer and cardiovascular disease is associated with higher viral loads even after adjusting for age. [Related pre-proof]

D-dimer as an indicator of prognosis in SARS-CoV-2 infection: a systematic review – ERJ Publications

Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) stimulates pro-thrombotic changes. This, combined with its tropism for endothelium and lung structures, may explain its association with thrombotic events, reduction of pulmonary gas exchange, acute respiratory distress syndrome (ARDS) and a composite end-point (intensive care unit, invasive ventilation, death). This study aims to highlight the correlation between elevated D-dimer (an indirect thrombosis marker) and the increased rate of poor prognosis-associated conditions, and to introduce D-dimer-labelled anticoagulant administration as a potentially useful tool to prevent complications and positively influence coronavirus disease 2019 (COVID-19) course.

Silent hypoxia in patients with SARS CoV-2 infection before hospital discharge – MDLinx

This study was intended to evaluate the degree of hypoxia and subjective dyspnoea elicited by a 6-minute walking test (6 MWT) in COVID-19 patients prior to discharge. Researchers conducted a 6 MWT in 26 discharge-ready COVID-19 patients without chronic pulmonary disease or cardiac failure. They tested heart rate, oxyhaemoglobin saturation (SpO2), respiratory rate, and subjective dyspnoea measured on the Borg CR-10 scale, before and immediately after the 6 MWT with continuous monitoring of SpO2 and heart rate during the 6 MWT. The findings revealed that in the diagnosis of asymptomatic exercise-induced hypoxia, the 6 MWT is a potential tool in hospitalized COVID-19 individuals prior to discharge. Due to important methodological limitations, further research is required to validate the data and to evaluate their clinical consequences. [Related Study]

Official Reporting for July 14, 2020