July 21, 2020

On today's episode we discuss: — Epidemiology: A retrospective cohort study from New York found that all 16 patients with confirmed SARS-CoV-2 that received a lower extremity computed tomography angiogram (CTA) over a 3-month time period had at least one blood clot on lower extremity CTA compared to just 69% (n=22/36) in propensity-matched patient control data. Limb amputation was also more frequent in COVID-19 patients versus patient controls with peripheral vascular disease, and those presenting with limb ischemia and respiratory symptoms had higher rates of amputation and mortality (p=0.001). Authors use this study to further highlight the morbidity and mortality associated with COVID-19 coagulopathy. — Transmission and Prevention: An analysis of contact tracing data from South Korea describes how age and proximity affect SARS-CoV-2 transmission within people living in the same household. They found: - Household contacts had a higher risk of transmission, with 11.8% of household contacts positive for COVID-19 compared to 1.9% of non-household contacts. - The highest rate of transmission was from the 10-19 year old age group (18.6%) - The lowest rate of transmission was from the 0-9 year old age group (5.3%), which was likely a result of stringent social distancing due to the typically high rate of infection transmission in preschool and daycare settings. — Management: A case report conducted at Changi General Hospital discusses a 45-year-old patient who was diagnosed with Hashimoto's thyroiditis following a COVID-19 infection, indicating a potential link between the hyper-inflammatory state caused by the SARS-CoV-2 virus and the development of autoimmune diseases. — R&D Diagnosis and Treatment: An analysis of laboratory tests, imaging results, and vaginal swabs of 13 pregnant persons with suspected COVID-19 found that 12 tested positive for SARS-CoV-2 via RT-PCR from respiratory tract samples, but all vaginal swab samples tested negative. These findings add to the growing evidence that sexual or vertical transmission of SARS-CoV-2 is unlikely and may assist in decision-making regarding obstetrical management.