RESOURCES: COVID-19 Related Peer Review Publications for HCPs
We live in unprecedented times with an overwhelming amount of information coming through.
We thought it would be helpful for those healthcare professionals managing people with diabetes at this time of COVID-19 when there is a rapidly changing evidence base, that we pull a list of peer review publications in the field which may be relevant to you as healthcare professionals or to help you care for your patients. We will keep this updated and of course if you are aware of important publications that come to light that that you would like us to add to the list please don’t hesitate to get in touch with us.
With kind regards
Kamlesh Khunti
Professor of Primary Care, Diabetes & Vascular Medicine
NIHR Senior Investigator
Co-Director Leicester Diabetes Centre
Melanie J Davies CBE
Professor of Diabetes Medicine
NIHR Senior Investigator Emeritus
Co-Director Leicester Diabetes Centre
Cardiovascular Disease
1) ACC CLINICAL BULLETIN COVID-19 Clinical Guidance For the CV Care Team
Current COVID-19 Clinical Context: More than 80% of infected patients experience mild symptoms and recover without intensive medical intervention. Morbidity and mortality increase significantly with age, rising to 8.0% among patients 70-79 and 14.8% in patients over 80 in large-scale Chinese case reporting. Patients with underlying comorbid conditions have a heighted risk for contracting COVID-19 and a worse prognosis. Case fatality rates for comorbid patients are materially higher than the average population, hypertension 6.0%, diabetes 7.3%, CVD 10.5%.
Acute Cardiac Complications of COVID-19: In a recent case report on 138 hospitalized COVID-19 patients, 16.7% of patients developed arrhythmia and 7.2% experienced acute cardiac injury. Cardiologists should be prepared to assist other clinical specialties in managing cardiac complications in severe cases of COVID-19
COVID-19 Implications For Patients With Underlying Cardiovascular Conditions: Patients with underlying cardiovascular disease are at higher risk of contracting COVID-19 and have a worse prognosis. Make plans for quickly identifying and isolating cardiovascular patients with COVID-19 symptoms from other patients, including in the ambulatory setting. It is reasonable to triage COVID-19 patients according to underlying cardiovascular, diabetic, respiratory, renal, oncological, or other comorbid conditions for prioritized treatment. Providers are cautioned that classic symptoms and presentation of AMI may be overshadowed in the context of COVID-19, resulting in underdiagnosis. For patients with heart failure or volume overload conditions, copious fluid administration for viral infection should be used cautiously and carefully monitored.
Cardiac-specific preparedness for COVID-19 is recommended.
2) Fang L et al. Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? Lancet Respir Med online March 11, 2020 https://doi.org/10.1016/S2213-2600(20)30116-8
3) Zheng YY et al. COVID-19 and the cardiovascular system. Nature Reviews Cardiology https://doi.org/10.1038/s41569-020-0360-5
SARS- CoV-2 is thought to infect host cells through ACE2 to cause COVID-19, while also causing damage to the myocardium, although the specific mechanisms are uncertain. Patients with underlying CVD and SARS- CoV-2 infection have an adverse prognosis. Therefore, particular attention should be given to cardiovascular protection during treatment for COVID-19.
4) Li B et al. Prevalence and impact of cardiovascular metabolic diseases on COVID‑19 in China. Clinical Research in Cardiology https://doi.org/10.1007/s00392-020-01626-9
Studies have reminded that cardiovascular metabolic comorbidities made patients more susceptible to suffer
2019 novel corona virus (2019-nCoV) disease (COVID-19), and exacerbated the infection. The aim of this analysis is to determine the association of cardiovascular metabolic diseases with the development of COVID-19. A meta-analysis of eligible 6 studies with 1527 patients that summarized the prevalence of cardiovascular metabolic diseases in COVID-19 and compared the incidences of the comorbidities in ICU/severe and non-ICU/severe patients was performed. The proportions of hypertension, cardia-cerebrovascular disease and diabetes in patients with COVID-19 were 17.1%, 16.4% and 9.7%, respectively. The incidences of hypertension, cardia-cerebrovascular diseases and diabetes were about twofolds, threefolds and twofolds, respectively, higher in ICU/severe cases than in their non-ICU/severe counterparts. At least 8.0% patients with COVID-19 suffered the acute cardiac injury. The incidence of acute cardiac injury was about 13 folds higher in ICU/severe patients compared with the non-ICU/severe patients. Patients with previous cardiovascular metabolic diseases may face a greater risk of developing into the severe condition and the comorbidities can also greatly affect the prognosis of the COVID-19. On the other hand, COVID-19 can, in turn, aggravate the damage to the heart.
5) Xiong TY et al. Coronaviruses and the cardiovascular system: acute and long-term implications. European Heart Journal (2020) doi:10.1093/eurheartj/ehaa231 https://www.acc.org/latest-in-cardiology/ten-points-to-remember/2020/03/20/08/56/coronaviruses-and-the-cardiovascular
In the largest published clinical cohort of COVID-19 to date, acute cardiac injury, shock, and arrhythmia were present in 7.2%, 8.7%, and 16.7% of patients, respectively, with higher prevalence amongst patients requiring intensive care. Early COVID-19 case reports suggest that patients with underlying conditions are at higher risk for complications or mortality—up to 50% of hospitalized patients have a chronic medical illness (40% cardiovascular or cerebrovascular disease). Pre-existing cardiovascular disease may contribute to adverse early clinical outcomes and infection may have longer-term implications for overall cardiovascular health. Interdisciplinary management of severe cases (with priority for those with pre-existing cardiovascular disease) and prolonged clinical follow-up are therefore essential.
Diabetes
1) Han X et al. A Diabetic Patient With 2019-nCoV Infection Who Recovered and Was Discharged From Hospital. J Thorac Imaging 2020 https://doi.org/10.1097/RTI.0000000000000506
2) Gupta R et al. Clinical considerations for patients with diabetes in times of COVID-19 epidemic. Diabetes & Metabolic Syndrome: Clinical Research & Reviews 14 (2020) 211-212 https://doi.org/10.1016/j.dsx.2020.03.002
A report of 72,314 cases of COVID-19 published by Chinese Centre for Disease Control and Prevention showed increased mortality in people with diabetes (2.3%, overall and 7.3%, patients with diabetes). For now, it is reasonable to assume that people with diabetes are at increased risk of developing infection with SARS-CoV-2. Coexisting heart disease, kidney disease, advanced age and frailty are likely to have further increase in the severity of disease. Diabetes-specific and general preventive actions as well as detailed measures in patients of diabetes with COVID 19 infection are suggested. Unproven therapies and future directions are also discussed.
3) Anne L. Peters: Everyone With Diabetes Must Prepare for COVID-19 https://www.medscape.com/viewarticle/926418?nlid=134478_435&src=WNL_mdplsfeat_200317_mscpedit_diab&uac=35186HG&spon=22&impID=2315077&faf=1
4) Diabetes, CVD Tied to Worse Prognosis for COVID-19 Infection https://www.medscape.com/viewarticle/925681
5) Glucose Control Key With COVID-19 in Diabetes, Say Experts https://www.medscape.com/viewarticle/927044?nlid=134581_3044&src=WNL_mdplsnews_200320_mscpedit_diab&uac=35186HG&spon=22&impID=2318466&faf=1
6) Ceriello A et al. Why is hyperglycemia worsening COVID-19 and its prognosis? Diabetes, Obesity and Metabolism online May 28, 2020 https://dom-pubs.onlinelibrary.wiley.com/doi/epdf/10.1111/dom.14098
7) Skinner T, Speight J. Supporting people with diabetes during a pandemic. Diabetic Medicine, Wiley Library online May 08, 2020 https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.14320
8) Jin-Kui Y et al. New onset COVID-19–related diabetes: an indicator of mortality. Medrxiv online June 26, 2020 https://dom-pubs.onlinelibrary.wiley.com/doi/epdf/10.1111/dom.14098
9) How do we recover from COVID‐19? Helping diabetes teams foresee and prepare for the psychological harms. Wiley online library July 06, 2020 https://onlinelibrary.wiley.com/doi/abs/10.1111/dme.14360
10) Apicella M et al. COVID-19 in people with diabetes: understanding the reasons for worse outcomes. The Lancet online July 17, 2020 https://www.thelancet.com/journals/landia/article/PIIS2213-8587(20)30238-2/fulltext
11) Coppelli A et al. Hyperglycemia at Hospital Admission Is Associated With Severity of the Prognosis in Patients Hospitalized for COVID-19: The Pisa COVID-19 Study. American Diabetes Association Online July 20, 2020 https://care.diabetesjournals.org/content/early/2020/08/07/dc20-1380
12) Barron E et al. Associations of type 1 and type 2 diabetes with COVID-19- related mortality in England: a whole-population study. The Lancet online August 13, 2020 https://www.thelancet.com/action/showPdf?pii=S2213-8587%2820%2930272-2
13) Caruso P et al. Diabetic Foot Problems During the COVID-19 Pandemic in a Tertiary Care Center: The Emergency Among the Emergencies. American Diabetes Association online October, 2020 https://care.diabetesjournals.org/content/43/10/e123
14) Sarah L et al. Caring for Older Adults With Diabetes During the COVID-19 Pandemic. JAMA Network online July 13, 2020 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2768362
15) Lawrence C et al. Increased paediatric presentations of severe diabetic ketoacidosis in an Australian tertiary centre during the COVID‐19 pandemic. Wiley online October 6, 2020 https://onlinelibrary.wiley.com/doi/full/10.1111/dme.14417?campaign=wolearlyview
16) Ghosh A et al. Glycemic parameters in new-onset diabetes during COVID-19 pandemic are more severe than new-onset diabetes before the pandemic: NOD COVID India Study. ELSEVIER December 18, 2020 https://drive.google.com/file/d/1agP6SS5RaHofDIBujMsbKMYVwGfdqlLN/view
17) Misra S et al. Comparison of Diabetic Ketoacidosis in Adults During the SARS-CoV-2 Outbreak and Over the Same Time Period for the Preceding 3 Years. Diabetes Care November, 2020 https://care.diabetesjournals.org/content/diacare/44/2/e29.full.pdf
Treatment/Pharmacotherapy
1) Cao B et al. A Trial of Lopinavir–Ritonavir in Adults Hospitalized with Severe Covid-19. N Engl J Med online March 18, 2020 DOI: 10.1056/NEJMoa2001282 https://www.nejm.org/doi/full/10.1056/NEJMoa2001282
A randomized, controlled, open-label trial involving hospitalized adult patients with confirmed SARS-CoV-2 infection, which causes the respiratory illness Covid-19 was conducted. Patients were randomly assigned in a 1:1 ratio to receive either lopinavir–ritonavir (400 mg and 100 mg, respectively) twice a day for 14 days, in addition to standard care, or standard care alone. The primary end point was the time to clinical improvement, defined as the time from randomization to either an improvement of two points on a seven-category ordinal scale or discharge from the hospital, whichever came first. In hospitalized adult patients with severe Covid-19, no benefit was observed with lopinavir– ritonavir treatment beyond standard care. Future trials in patients with severe illness may help to confirm or exclude the possibility of a treatment benefit.
2) Raden LR, Rubin EJ. Covid-19 — The Search for Effective Therapy. N Engl J Med online March 18, 2020 DOI: 10.1056/NEJMe2005477 https://www.nejm.org/doi/10.1056/NEJMe2005477
3) Gautret et al. (2020) Hydroxychloroquine and azithromycin as a treatment of COVID‐19: results of an open‐label non‐randomized clinical trial. International Journal of Antimicrobial Agents – In Press 17 March 2020 – DOI : 10.1016/j.ijantimicag.2020.105949 https://www.mediterranee-infection.com/wp-content/uploads/2020/03/Hydroxychloroquine_final_DOI_IJAA.pdf
4) Are Warnings Against NSAIDs in COVID-19 Warranted? https://www.medscape.com/viewarticle/926940?nlid=134581_3044&src=WNL_mdplsnews_200320_mscpedit_diab&uac=35186HG&spon=22&impID=2318466&faf=1#vp_1
5) Horby P et al. Effect of Dexamethasone in Hospitalized Patients with COVID-19: Preliminary Report. Medrxiv online June 22, 2020 DOI: 10.1101/2020.06.22.20137273 https://www.medrxiv.org/content/10.1101/2020.06.22.20137273v1
6) Siemieniuk R et al. Drug treatments for covid-19: living systematic review and network meta-analysis. The bmj online July 30, 2020 https://www.bmj.com/content/370/bmj.m2980
7) Rayman G et al. Dexamethasone therapy in COVID‐19 patients: implications and guidance for the management of blood glucose in people with and without diabetes. Wiley Online August 2, 2020 https://onlinelibrary.wiley.com/doi/full/10.1111/dme.14378
8) COVID-19: Treatment for older people in the community. British Geriatrics Society January 26, 2021 https://www.bgs.org.uk/resources/covid-19-treatment-for-older-people-in-the-community
General
1) Zhu N et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med 2020;382:727-33. DOI: 10.1056/NEJMoa2001017 https://www.nejm.org/doi/full/10.1056/NEJMoa2001017
2) Fauci AS et al. Covid-19 — Navigating the Uncharted. N Engl J Med 2020 DOI: 10.1056/NEJMe2002387 https://www.nejm.org/doi/full/10.1056/NEJMe2002387
3) Webster P: Canada and COVID-19: learning from SARS. Lancet 2020; 395: 936-937 DOI: https://doi.org/10.1016/S0140-6736(20)30670-X
4) Emma E et al. Psychological Distress and Loneliness Reported by US Adults in 2018 and April 2020. JAMA online June 3, 2020 doi:10.1001/jama.2020.9740 https://jamanetwork.com/journals/jama/fullarticle/2766941
5) BMJ. Characteristics and outcomes of pregnant women admitted to hospital with confirmed SARS-CoV-2 infection in UK: national population based cohort study. BMJ online June 8, 2020 https://www.bmj.com/content/369/bmj.m2107
6) Chudasama Y et al. Impact of COVID-19 on routine care for chronic diseases: A global survey of views from healthcare professionals. Science Direct online June 23, 2020 doi:10.1016/j.dsx.2020.06.042 https://www.sciencedirect.com/science/article/pii/S1871402120302113
7) Hewitt J et al. The effect of frailty on survival in patients with COVID-19 (COPE): a multicentre, European, observational cohort study. The Lancet online June 30, 2020 https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(20)30146-8/fulltext?utm_campaign=tlcoronavirus20&utm_content=133309248&utm_medium=social&utm_source=twitter&hss_channel=tw-27013292
8) Matthias Pierce et al. Mental health before and during the COVID-19 pandemic: a longitudinal probability sample survey of the UK population. The Lancet online July 21, 2020 https://www.thelancet.com/action/showPdf?pii=S2215-0366%2820%2930308-4
9) Banda J et al. Long-term patient-reported symptoms of COVID-19: an analysis of social media data. Medrxiv online Aug 1, 2020 https://www.medrxiv.org/content/10.1101/2020.07.29.20164418v1.full.pdf
10) Goldman B. Study reveals immune-system deviations in severe COVID-19 cases. Stanford Medicine online Aug 11, 2020 https://med.stanford.edu/news/all-news/2020/08/immune-system-deviations-found-in-severe-covid-19-cases.html?sf126663591=1
11) Davis H et al. Characterizing Long COVID in an International Cohort: 7 Months of Symptoms and Their Impact. Medrxiv online December 27, 2020 https://www.medrxiv.org/content/10.1101/2020.12.24.20248802v2.full.pdf
12) Jacob L et al. Change in glucose‐lowering medication regimens in individuals with type 2 diabetes mellitus during the COVID‐19 pandemic in Germany. Wiley online December 15, 2020 https://dom-pubs.onlinelibrary.wiley.com/doi/full/10.1111/dom.14293?campaign=wolearlyview
13) Michelen M L et al. Characterising long-term covid-19: a rapid living systematic review. Medrxiv online December 9, 2020 https://www.medrxiv.org/content/10.1101/2020.12.08.20246025v1.full.pdf
14) Levene L et al. Pandemic threatens primary care for long term conditions. The BMJ October 5, 2020 https://www.bmj.com/content/371/bmj.m3793
Epidemiology
1) Khunti K et al. Covid-19 in ethnic minority groups: where do we go following PHE’s report?. The BMJ Opinion Online June 8, 2020 https://blogs.bmj.com/bmj/2020/06/08/covid-19-in-ethnic-minority-groups-where-do-we-go-following-phes-report/
2) Li Q et al. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia. N Engl J Med 2020 DOI: 10.1056/NEJMoa2001316 https://www.nejm.org/doi/full/10.1056/NEJMoa2001316
3) Khunti K et al. COVID-19 and ethnicity: who will research results apply to?. The Lancet Online June 12, 2020 DOI 10.1016/ S0140-6736(20)31380-5 https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(20)31380-5.pdf
4) Kumar Singh A et al. Prevalence of comorbidities and their association with mortality in patients with COVID ‐19: A Systematic Review and Meta‐analysis. Diabetes, Obesity and Metabolism Online June 23, 2020 DOI 10.1111/dom.14124 https://dom-pubs.onlinelibrary.wiley.com/doi/epdf/10.1111/dom.14124
5) Razieh C et al. Body mass index and risk of COVID ‐19 across ethnic groups: analysis of UK Biobank study. Diabetes, Obesity and Metabolism Online June 29, 2020 DOI 10.1111/dom.14125 https://dom-pubs.onlinelibrary.wiley.com/doi/epdf/10.1111/dom.14125
6) Carl-Etienne Juneau et al. Effective Contact Tracing for COVID-19: A Systematic Review. Medrxiv Online June 24, 2020 https://www.medrxiv.org/content/10.1101/2020.07.23.20160234v1.full.pdf
7) Patrice Carter et al. What factors influence symptom reporting during an emerging infectious disease outbreak? A rapid review of the evidence. Medrxiv Online June 24, 2020 https://www.medrxiv.org/content/10.1101/2020.07.23.20159897v1.full.pdf
8) Tartof S et al. Obesity and Mortality Among Patients Diagnosed With COVID-19: Results From an Integrated Health Care Organization. ACP Journals Online August 12, 2020 https://www.acpjournals.org/doi/10.7326/M20-3742
9) Ssentongo P et al. Association of cardiovascular disease and 10 other pre-existing comorbidities with COVID-19 mortality: A systematic review and meta-analysis. Plos One Journals Online August 26, 2020 https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0238215
10) Popkin B et al. Individuals with obesity and COVID‐19: A global perspective on the epidemiology and biological relationships. Wiley Online August 26, 2020 https://onlinelibrary.wiley.com/doi/10.1111/obr.13128
11) Elizabeth M et al. Asymptomatic and Presymptomatic Severe Acute Respiratory Syndrome Coronavirus 2 Infection Rates in a Multistate Sample of Skilled Nursing Facilities. JAMA Online October 19, 2020 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2771816
12) Ekezie W et al. The views of ethnic minority and vulnerable communities towards participation in COVID-19 vaccine trials. Oxford Academic Online October 30, 2020 https://academic.oup.com/jpubhealth/advance-article/doi/10.1093/pubmed/fdaa196/5942929
13) Dorjee K et al. Prevalence and predictors of death and severe disease in patients hospitalized due to COVID-19: A comprehensive systematic review and meta-analysis of 77 studies and 38,000 patients. Plos One Online December 7, 2020 https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0243191
14) Ayoubkhani D et al. Epidemiology of post-COVID syndrome following hospitalisation with coronavirus: a retrospective cohort study. Medrxiv Online January 15, 2021 https://www.medrxiv.org/content/10.1101/2021.01.15.21249885v1
Case Studies
1) Holshue ML et al. First Case of 2019 Novel Coronavirus in the United States. N Engl J Med 2020;382:929-36. DOI: 10.1056/NEJMoa2001191 https://www.nejm.org/doi/full/10.1056/NEJMoa2001191
2) Anne L. Peters: Diabetes and COVID-19: Three Patient Cases https://www.medscape.com/viewarticle/926955#vp_2
Infection Control/Prevention
1) Deng SQ, Peng HJ. Characteristics of and Public Health Responses to the Coronavirus Disease 2019 Outbreak in China. J. Clin. Med. 2020, 9, 575; https://doi:10.3390/jcm9020575
2) Parodi SM, Liu VX. From Containment to Mitigation of COVID-19 in the US. JAMA online March 13, 2020. doi:10.1001/jama.2020.3882 https://jamanetwork.com/journals/jama/fullarticle/2763187
3) Ong SWX et al. Air, Surface Environmental, and Personal Protective Equipment Contamination by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) From a Symptomatic Patient. JAMA online March 4, 2020. doi:10.1001/jama.2020.3227 https://jamanetwork.com/journals/jama/fullarticle/2762692
4) Greenlaigh T. Face coverings for the public: Laying straw men to rest. Wiley Online Library online May 26, 2020 https://onlinelibrary.wiley.com/doi/10.1111/jep.13415
5) Perski O et al. Face masks to prevent community transmission of viral respiratory infections: A rapid evidence review using Bayesian analysis. Qeios online May 1, 2020 https://www.qeios.com/read/1SC5L4
Clinical
1) Guan W et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med 2020 DOI: 10.1056/NEJMoa2002032 https://www.nejm.org/doi/full/10.1056/NEJMoa2002032
2) Yang X et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med 2020 Online February 21, 2020 https://doi.org/10.1016/S2213-2600(20)30079-5
3) Huang C et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395: 497–506 https://doi.org/10.1016/S0140-6736(20)30183-5
4) Zhou F et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet online March 9, 2020 https://doi.org/10.1016/S0140-6736(20)30566-3
5) Weiss P, Murdoch DR. Clinical course and mortality risk of severe COVID-19. Lancet online March 17, 2020 https://doi.org/10.1016/S0140-6736(20)30633-4
6) Zhang JJ et al. Clinical characteristics of 140 patients infected with SARSCoV-2 in Wuhan, China. Allergy 2020 DOI: 10.1111/all.14238 https://doi.org/10.3390/jcm9020575
7) Murthy S et al. Care for Critically Ill Patients With COVID-19. JAMA online March 11, 2020. https://doi.org/10.1001/jama.2020.3633
Initial reports suggest that COVID-19 is associated with severe disease that requires intensive care in approximately 5% of proven infections. persons. Patients who have required critical care have tended to be older (median age ≈60years), and 40% have had comorbid conditions, commonly diabetes and cardiac disease. While mortality among all infected patients may be in the range of 0.5%to 4%,among patients who require hospitalization, mortality may be approximately 5%to 15%, and for those who become critically ill, there is currently a wide mortality range, from 22% to 62% in the early Hubei Province case series. The exact cause of death is unclear at this point, with progressive hypoxia and multiorgan dysfunction being the presumed causes. The principal feature of patients with severe disease is the development of ARDS: a syndrome characterized by acute onset of hypoxemic respiratory failure with bilateral infiltrates. Evidence-based treatment guidelines for ARDS should be followed; however, with modifications to usual critical care by additional precautions to reduce risk of COVID-19 transmission.
8) Wu C et al. Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China. JAMA Intern Med. online March 13, 2020 doi:10.1001/jamainternmed.2020.0994 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2763184
9) Wu Z, McGoogan. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA online February 24, 2020. doi:10.1001/jama.2020.2648 https://jamanetwork.com/journals/jama/fullarticle/2762130
Most case patients were 30 to 79 years of age (87%) and most cases were classified as mild (81%; ie, nonpneumonia and mild pneumonia). However, 14% were severe and 5% were critical (ie, respiratory failure, septic shock, and/or multiple organ dysfunction or failure). The overall case-fatality rate (CFR) was 2.3% (1023 deaths among 44 672 confirmed cases). No deaths occurred in the group aged 9 years and younger, but cases in those aged 70 to 79 years had an 8.0% CFR and cases in those aged 80 years and older had a 14.8%CFR. No deaths were reported among mild and severe cases. The CFR was 49.0%
10) Han M S et al. Clinical Characteristics and Viral RNA Detection in Children With Coronavirus Disease 2019 in the Republic of Korea. JAMA online August 28, 2020. https://jamanetwork.com/journals/jamapediatrics/fullarticle/2770150
11) Greenhalgh T et al. Management of post-acute covid-19 in primary care. The BMJ online August 11, 2020. https://www.bmj.com/content/370/bmj.m3026
Pathology
1) Matthijs K et al. Cytokine Levels in Critically Ill Patients With COVID-19 and Other Conditions. JAMA Network online September 03, 2020. https://jamanetwork.com/journals/jama/article-abstract/2770484
2) Lowenstein C et al. Severe COVID-19 is a Microvascular Disease. AHA Journals online September 09, 2020. https://www.ahajournals.org/doi/pdf/10.1161/CIRCULATIONAHA.120.050354
3) Wise J. Covid-19: T cell response lasts for at least six months after infection, study shows. BMJ online November 02, 2020. https://www.bmj.com/content/371/bmj.m4257