March 360: Trending Infectious Disease News of the Month

As March comes to an end, we’re looking back at an unprecedented month in infectious disease news.

The novel coronavirus (SARS-CoV-2) first came to the surface in late December when a cluster of pneumonia cases of then-unknown etiology was reported in Wuhan, China. The situation has now progressed and on March 11^th, the World Health Organization (WHO) declared the coronavirus disease 2019 (COVID-19) outbreak a pandemic.

The same day, Italy instituted the first large-scale lockdown seen outside of China, closing schools, canceling events, and restricting travel.

At that point, many universities and colleges in the United States had extended their spring breaks or shut down entirely, and on March 14^th, the federal government declared a national emergency.

Within the health care community, it became questionable whether holding upcoming conferences would be responsible given the risk of SARS-CoV-2 transmission.

Some conferences turned to digital solutions. Contagion® was able to provide in-depth coverage of this year’s all-virtual annual Conference on Retroviruses and Opportunistic Infections (CROI 2020).

Among many notable presentations was the publication of 96-week results from the DISCOVER trial of tenofovir alafenamide for pre-exposure prophylaxis (PrEP). The new formulation has sparked debate, as some point to likely superiority in terms of renal safety while others note that the new formulation comes just as a generic PrEP option is likely to be widely available at lower cost.

As the month continued and confirmed COVID-19 cases climbed, the response in many countries changed from containment to mitigation. Many nations closed their borders, including European Union affiliated states.

In the United States, testing efforts were scaled-up over the course of the month. The US Food and Drug Administration (FDA) issued emergency use authorizations for several COVID-19 diagnostics, including a 5-minute test.

The Krammer Lab at the Icahn School of Medicine at Mount Sinai Health System in New York City also completed development of the US’s first serological assay to detect past infection through immune response.

As of March 30^th, 20 Emergency Use Authorizations for different COVID-19 diagnostics have been issued by the FDA.

To stay up to date with the trajectory of the COVID-19 pandemic moving forward, check out our daily coronavirus News Network updates by searching for Contagion Connect on Spotify, Google Podcasts, Castbox, or Deezer. Segments from before March 30 are available on Youtube.

Amid developments in the COVID-19 pandemic, Contagion® continued to focus on other infectious disease news.

In some of the month’s brighter news, the last confirmed Ebola patient in the Democratic Republic of the Congo was released from care, but health officials warned that the situation is still precarious until more time has passed without any new cases.

In other infectious disease news, the results of the CRACKLE-2 study were published, revealing a surprising heterogeneity among US Centers for Disease Control and Prevention (CDC) defined carbapenem-resistant Enterobacteriaceae (CRE) despite similar clinical outcomes.

Importantly, the health care community recognized World TB Day on March 24. The day is recognized in order to raise awareness of an infectious disease which led to 10 million illnesses and 1.5 million deaths in 2018 alone.

As always, use the Contagion® Outbreak Monitor to learn more about infectious disease outbreaks in your area and around the world.

Here’s a look at the top 5 web articles from the month of March:

#5: Is There Any Reason to Use Corticosteroids in Coronavirus Treatment?

The clinical course and disease progression of COVID-19 is still unknown, and in the absence of a treatment with proven efficacy many different therapies are being deployed in hopes of treating those who fall ill.

A new commentary emphasizes that there is no evidence that patients with COVID-19 associated lung injury will benefit from the addition of corticosteroids to their therapeutic regimen. In fact, there is evidence it is more likely that they will be harmed by the addition.

Read the full story.

#4: How Does Hydroxychloroquine and Azithromycin Combination Therapy Measure Up For COVID-19 Treatment?

Jason Pogue, PharmD, BCPS, BCIDP, clinical professor of infectious diseases, at the University of Michigan College of Pharmacy, speaks with Contagion®’s Senior Editor Michaela Fleming to share his thoughts on the recently published study “Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open label non-randomized clinical trial.”

Read or watch the interview.

#3: COVID-19: New Jersey Institutes Statewide Curfew

New Jersey officials have implemented a statewide curfew in response to the COVID-19 pandemic.

New Jersey, along with New York and Connecticut required casinos, movie theaters, and gyms to be shut down at 8pm and remain closed until further notice. Restaurants and bars will be limited to take-out and delivery services only.

Read the full story.

#2: Coronavirus Incubation Period is About 5 Days, Study Estimates

The median incubation period for the novel coronavirus is about 5 days—which is similar to SARS, according to a paper published in the Annals of Internal Medicine.

Investigators from Johns Hopkins Bloomberg School of Public Health analyzed published information about the coronavirus in order to estimate the length of the incubation period from exposure to symptom onset. The investigators used news reports, public health reports, and press releases from 50 provinces, regions, and countries outside of the outbreak’s epicenter in Wuhan, China.

Read the full story.

#1: Gastrointestinal Symptoms Could Be New Focus for Coronavirus Diagnosis

Novel coronavirus symptoms seem to be mostly focused on fever and cough, but gastrointestinal symptoms should be a new focus for clinicians, according to 2 new papers published online in Gastroenterology.

The first paper describes how investigators from Shanghai, China, sought to document the symptoms of the novel coronavirus. Although fever, dry cough, and dyspnea present in most cases, they wanted to understand what impact the virus had on symptoms such as diarrhea, nausea, vomiting, and abdominal discomfort. So far, those symptoms have varied among different study populations, the authors wrote.

Former studies on SARS, which is related to the coronavirus and can present with similar symptoms, showed that SARS was verified in patients after detection in biopsy specimens and stool. This was true even after the patients had been discharged from the hospital.

The study authors noted that the first US patient admitted to a hospital with confirmed coronavirus had a loose bowel movement on hospital day 2. Labs in China have been able to isolate the live coronavirus from stool of patients, the study authors said. These factors brought the gastrointestinal tract to the forefront of investigators’ minds and suggest that clinicians should identify patients with gastrointestinal symptoms and carefully monitor those patients.

Read the full story.