News scan on November 4, 2020

Infected siblings, Hispanic ethnicity increase children’s COVID-19 risk, data show

Yesterday’s Duke University study Clinical infections We found an infection rate of 77% in children with close contact with COVID-19 cases and provided evidence of efficient viral infection in children. Hispanic ethnicity and having siblings infected with SARS-CoV-2 were risk factors, but asthma was associated with a reduced risk.

Current epidemiological data suggest that children are less susceptible to SARS-CoV-2 infection than adults, have milder illness, and have lower seizure and hospitalization rates. It is unclear whether these differences are due to different exposures or age-related biological differences, and data on child transmission efficiency are limited.

The authors conducted a prospective cohort study of 382 unhospitalized children (under 21 years) in North Carolina from April 7 to July 16 with close contact with COVID-19 positivity. Did. 2 to 7 days before the onset of symptoms or laboratory-confirmed infection.

The authors found that 77% of children with close contact with infection (293 out of 382) were positive for SARS-CoV-2, the virus that causes COVID-19. Infected children were more likely to be Hispanic (88% vs. 57%) P <0.0001), low likelihood of asthma (6% vs. 17%, P = 0.005), and likely to have contact with infected siblings (49% vs. 29%, P = 0.001) Than an uninfected child.

Researchers have identified age-related fluctuations in symptoms, with children aged 6 to 13 years often asymptomatic (39%) and having respiratory symptoms less frequently than younger children () 29% vs. 48%, P = 0.01) or adolescents over 14 years old (29% vs. 60%, P <0.0001). Adolescents had a longer illness than infants (median duration 7 days vs. 4) P = 0.01) However, no age-related differences in viral load were observed between symptomatic and asymptomatic patients.

Increased risk for Hispanic children National data It shows that 42% of 161,387 school-aged children who tested positive for SARS-CoV-2 were Hispanic.

“The underlying factors of SARS-CoV-2 infection rates and the resulting racial and ethnic disparities require further study, but they are the higher prevalence of essential workers, dense living conditions. , And may be related to structural inequality, including socio-economic factors, “the author wrote.
November 3rd Clin Infect Dis Survey

COVID-19 / Racial disparity in outcomes of rheumatoid arthritis

A study of 1,324 patients with both COVID-19 and rheumatoid arthritis showed that yesterday’s study was up to 2.74 times more likely to hospitalize minority patients than white patients. .. Arthritis and rheumatology..

Of the population of this study, 51% of black patients, 43% of Asian patients, 37% of Latin patients, 35% of mixed / other racial patients, and 29% of Caucasian patients were hospitalized. In terms of odds ratio, it means that black patients are 2.74 times more likely to be hospitalized, Asians 2.69 times, Latino Americans 1.71 times, and others / mixed races 2.59 times more likely than white patients. ..

Researchers found that there was greater racial / ethnic disparity when examining ventilator needs and mortality (Latin Americans need ventilator support more than white patients). These findings were not statistically significant (including the fact that they are 3.25 times more likely to be).

Senior authors Jinoos Yazdany, MD, and MPH wrote in a press release from journal publisher Wiley, “These data further exacerbate the health inequalities that current pandemics already have in many patients with rheumatoid arthritis. It suggests that it be done. ” Patients at high risk of severe infection, regardless of pathogen.

In total, 36% of all patients were hospitalized (26% required mechanical ventilation) and 6% died. Data were taken from the COVID-19 Global Rheumatoid Alliance Physician Registration from March 24th to August 26th. Results were measured to manage gender, age, and characteristics and comorbidities such as hypertension / cardiovascular disease, lung disease, and diabetes. Researchers say that the limits of research include potential self-reporting bias, lack of information, and racial misclassification.
November 3rd Rheumatoid arthritis Survey
November 4th Wiley Press release

Reviews show that age, gender, and underlying conditions predict COVID-19 mortality

A PLOS One Yesterday’s study showed that age, gender, and health were strong predictors of COVID-19 mortality in inpatients, and epidemiological data needed to be stratified to more accurately predict clinical outcomes. The sex is highlighted.

Data showing a consistent association between age, male gender, comorbidities, and poor prognosis for COVID-19 have so far predicted predictive values ​​of other factors such as smoking, clinical symptoms, test parameters, and It is not possible to understand how these differ between different socio-demographic populations. And epidemiological profile. The meta-analysis used data from 60 hospital studies in 13 countries from December 24th to May 17th, 2019. This included 51,225 COVID-19 patients, of whom 12,458 (24.3%) died.

Higher risk of in-hospital death was seen in all patients with shortness of breath (pooled odds ratio) [OR], 2.5), smoking habits (OR, 1.6), and some comorbidities including lung, cardiovascular, cerebrovascular, kidney, and liver diseases; hypertension; diabetes; and malignant cancer. However, the findings reveal substantial age-related changes in the predicted clinical status of COVID-19 mortality.

The increased risk of death from shortness of breath and smoking was higher in studies of patients younger than 60 years than in older patients (OR 4.3 vs 1.6 and 2.8 vs 1.2, respectively), in the following patients: It suggests that special attention needs to be paid. Pulmonary dysfunction. The most important predictors of mortality in older patients are liver function-related indicators, urea nitrogen, and inflammatory factors, indicating the possibility of using elevated biochemical markers to identify older patients with poor prognosis. I will.

Previous studies have found an association between obesity and an increased risk of serious outcomes, but meta-analyses show increased mortality in obese patients only in studies with fewer chronic or severely ill patients. I did. Researchers suggest that body mass index is a more reliable prognostic factor in patients with fewer comorbidities.

The authors conclude that “epidemiological data stratified by age, gender, and baseline chronic status are needed to enable more accurate decisions that take into account predictors of COVID mortality.” It is attached.
November 3rd PLOS One Survey

More H5N8 bird flu outbreaks noted in Israeli and South Korean poultry and wild birds

Israeli veterinary authorities have reported another highly pathogenic H5N8 avian influenza outbreak in poultry, according to today’s notice from the World Organization for Animal Health (OIE). This is part of a pattern that started in mid-October.

The event began on November 1st at the broiler farm in Hazafon, another area of ​​recent outbreaks. The virus killed 1,420 of the 133,000 susceptible birds, and all surviving birds were slaughtered.

Elsewhere, South Korea today reported outbreaks of H5N8 in two wild birds, South Zhongqing Province and Gyeonggi Province in the west. The event began on October 21st and 24th, affecting mandarin ducks, and the virus was identified in wild bird droppings as part of bird flu surveillance.

The outbreak in Gyeonggi Province occurred in an area inhabited by nearly 3,000 migratory birds of 38 species.
November 4th OIE Report Israeli H5N8
November 4th OIE Report Korean H5N8