CDC Fixes Test & Varying symptoms

by shawns333

www.medpagetoday.com/infectiousdisease/covid19/85156

Came across this interesting article on Friday with some good information:

CDC officials said Friday that they had solved problems with COVID-19 coronavirus testing kits for state and local public health departments, which had plagued the agency over the last couple weeks: use only two components, and ignore the problematic one.

As we’ve known for some time, it’s clear that the US can not test for COVID-19 in many places at all. Here’s the latest:

Messonnier previously said 12 state and local public health departments have the ability to test for COVID-19 coronavirus. The agency’s goal is that “every state and local health department” has that ability by the end of next week, she said.

There still seems to be some hierarchical flow in terms of who gets to report numbers, see here:

Ideally, this would allow states to report their own numbers of cases, though Messonnier said they are still working through “procedures … with states and the FDA in terms of confirmatory testing.”

Here’s their plan for now:

While CDC works to get out these new testing kits, work on COVID-19 coronavirus surveillance continues. Messonnier noted that next week, the first six influenza surveillance sites should begin testing for COVID-19, with the hope to “rapidly move from six to all 50 states,” she said.

The article cited some interesting stats from the Chinese 1,100 patient cohort that the New England Journal of Medicine reported also on Friday (www.nejm.org/doi/full/10.1056/NEJMoa2002032):

They examined data from about 1,100 patients with laboratory-confirmed COVID-19 in 552 hospitals in 30 Chinese provinces through Jan. 29. Patients’ median age was 47, and 42% were women. Just under one-quarter had a preexisting condition, such as hypertension or COPD.

Almost half that were admitted required mechanical ventilation (!):

Overall, about 5% were admitted to the ICU, 2.3% required mechanical ventilation, and 1.4% died.

Here are how things progressed for the patients and how they presented initially:

Cough was the most common symptom, with over two-thirds presenting with cough upon admission. Interestingly, only about 40% presented with fever, though nearly all developed fever while hospitalized. The authors also noted that about 16% of patients developed “severe illness” after admission to the hospital.

Here is some additional information about the patients studied:

Over 80% of patients had lymphocytopenia present at admission, and most had elevated levels of C-reactive protein.

Researchers reported a median incubation period of 4 days. While ground-glass opacity was the most common finding on chest CT imaging, they added that in 18% of non-severe cases, no radiographic or CT abnormality was found.

Around 60% of patients received intravenous antibiotics, while about 35% received oseltamivir therapy. About 40% of patients required oxygen therapy.

Patients stayed in the hospital for a median of 12 days, during which time most received a diagnosis of pneumonia.