COVID-19 scan on November 13, 2020

Possible treatments for fluvoxamine for mild to moderate COVID

In a preliminary study of 152 patients with mild to moderate COVID-19 infection, the 80 group of patients who took the antidepressant fluvoxamine for 15 days had clinical deterioration instead of six. Did not report (8.3%) out of 72 people who took placebo.

Study published yesterday JAMAClinical deterioration was defined as severe shortness of breath, hospitalization for shortness of breath or pneumonia, or oxygen saturation below 92% without assistance.

Both groups had fewer symptoms of adverse events, while the fluvoxamine group did not report serious results during treatment, while the placebo group included four patients requiring readmission. (One of the serious adverse events in the treatment group was a headache that required hospitalization during a 30-day follow-up period.) Side effects such as muscle pain, nausea, pneumonia, and vomiting occurred 11 times in the treatment group, 12 Reported times. Patients may have experienced multiple adverse events, albeit several times in the placebo group.

Patients in the St. Louis area participated in a remote study from April 10 to August 5, with September 19 as the last 30 days of follow-up. The median time from onset of symptoms to initial treatment was 4 days, and patients taking fluvoxamine took 100 milligrams 3 times daily for 15 days. 18.1% of people (18 under treatment and 19 in the placebo group) stopped responding to the survey before the treatment cycle was complete, but no one visited major regional hospitals or emergency departments. ..

“There are several ways this drug may work to help patients with COVID-19, but we say it may interact with the sigma-1 receptor to reduce the production of inflammatory molecules. I think, “said senior author Angela M Reiersen, MD, MPE, a press release from the University of Washington School of Medicine. “Past studies have shown that fluvoxamine can reduce inflammation in animal models of sepsis, which may be the same in our patients.”

In the editor’s note JAMA The editors said the study “provides only preliminary information and needs confirmation in larger trials, but at the same time it is a double-blind, placebo-controlled, randomized clinical trial and generally Minimizes bias and supports causal reasoning. “
November 12 JAMA Survey
November 12 University of Washington Press release

CDC: Symptom-based COVID-19 airport screening is ineffective

Data released today Weekly morbidity and mortality reports (MMWR)) Indicates that resource-intensive symptom-based airline passenger immigration screening rarely identified cases of COVID-19 diagnosed in the laboratory. Researchers also emphasized the insufficiency of electronic airline data for contact tracking and found that only 22% of records contained both the traveler’s phone number and address.

In January, the US Centers for Disease Control and Prevention (CDC) was symptomatically enhanced for passengers returning from certain countries after a widespread infection with SARS-CoV-2, the virus responsible for COVID-19. Screening has started. Over time, initial screening of passengers arriving at three major US airports from Wuhan in China will include travelers arriving at 15 US airports from mainland China, Iran, Europe, the United Kingdom, Ireland and Brazil. It has been enlarged.

From January 17th to September 13th, a total of 766,044 travelers were screened, 298 (0.04%) met the criteria for public health assessment, and 35 (0.005%) were tested for SARS-CoV-2. 9 people (0.001%) received positive test results. Manual data collection resulted in a complete record of 98.1%, including both the traveler’s phone number and address.

“Symptom-based screening programs are ineffective due to nonspecific clinical symptoms and asymptomatic cases of COVID-19,” wrote a CDC expert.

Due to low yields of positive cases, enhanced screening was discontinued on September 14 and replaced with recommendations for travel mask use, hand hygiene, symptom self-monitoring, and physical distance during and after travel. Was done. CDC experts also recommend additional traveler precautions, including pre-departure and post-arrival inspections, avoiding contact with high-risk people, and quarantine recommended by local public health authorities at the traveler’s destination. doing.

After enhanced screening and discontinuation of manual data collection, only 22% of traveler contact information records were completed.

“CDC works with government and industry partners to electronically collect reliable contact information for airline passengers before arriving in the United States for safety for public health follow-up, including air travel. We are developing a framework that enables real-time data transfer. Contact tracing, if necessary, “he said.
November 13 MMWR Survey

The study spotlights mental health emergencies in children during a pandemic

another MMWR According to today’s study, during the early months of the US COVID-19 pandemic, emergency department (ED) visits for mental health decreased in people of all ages, but children for all pediatric ED visits. The proportion of mental health-related visits to the United States increased in April. And it remained rising until October. Adolescents aged 12 to 17 accounted for the largest proportion of visits.

Compared to mid-March-October 2019 data, the proportion of mental health-related ED visits in 2020 increased by 24% and 31% for children aged 5-11 and adolescents aged 12-17, respectively. did. The proportion of mental health-related emergency outpatients for all children increased by 66%, from 1,094 per 100,000 in April 2019 to 1,820 per 100,000 in April 2020.

“The average proportion of children’s mental health-related emergency outpatients was about 44% higher in 2020 (1,673 per 100,000) than in 2019 (1,161 per 100,000),” the study authors found. ..

“Many mental illnesses begin in childhood, and mental health concerns in these age groups are sudden pandemics and daily activities associated with mitigation efforts, such as anxiety about illness, social isolation, and disruption of school connections. It can be exacerbated by the stress associated with the confusion. “They added.

CDCs and US healthcare professionals say that the emergency department (often the first care point for children’s mental health emergencies) has increased pediatric mental health visits due to pandemic-related barriers to non-emergency services. He pointed out that he may have experienced it.

“It is important during the COVID-19 pandemic to monitor children’s mental health indicators, promote coping and resilience, and increase access to services that support children’s mental health,” the author concludes. I did.
November 13 MMWR Survey