News Scan for Apr 30, 2021

Study finds low charge of mom-to-baby COVID-19 unfold, impact on infants

Infants born to girls with COVID-19 have a low likelihood of contracting the illness from their moms and having problems, based on a research revealed yesterday in JAMA.

The research included 88,159 Swedish newborns, 92% of these born within the nation from Mar 11, 2020, to Jan 31, 2021. Of these, 2,323 (1.6%) had been delivered by moms who examined optimistic for COVID-19, and solely 21 infants in that group (0.9%) examined optimistic for COVID-19 themselves.

The imply gestational age amongst infants born to girls with COVID was 39.2 weeks, in contrast with 39.6 weeks within the non-COVID group, and preterm delivery charges had been 8.8% versus 5.5%, respectively. Mortality was larger in infants who had moms with COVID-19 (0.3% vs 0.12%), however the researchers say this distinction is statistically insignificant, as is the size of hospital keep and breastfeeding charges.

In a matched cohort (infants from COVID-positive moms with as much as 4 infants from moms with out a optimistic COVID-19 prognosis), infants within the maternal COVID-19 group had been extra prone to want neonatal care (11.7% vs 8.4%; odds ratio [OR], 1.47), or have respiratory misery syndrome (1.2% vs 0.5%; OR, 2.40), any neonatal respiratory dysfunction (2.8% vs 2.0%; OR, 1.42), or hyperbilirubinemia, which ends up in jaundice (3.6% vs 2.5%; OR, 1.47).

“This study found support for preterm birth being an important mediator of the association between maternal SARS-CoV-2 and increased neonatal respiratory morbidity,” write the researchers, “whereas no statistically significant direct, infectious association with maternal SARS-CoV-2 could be demonstrated.”

Bias choice could have handed over girls with asymptomatic COVID and homed in on girls with extra extreme COVID-19 throughout testing selections, word Dani Dumitriu, MD, PhD, and Cynthia Gyamfi-Bannerman, MD, in an editorial in the identical journal. “Taken together with the lack of information on maternal illness severity and infection timing, the reported associations are likely to overestimate true neonatal morbidity,” they write.

“Our study suggests that mother and baby can be cared for together and that nursing can be recommended without danger to the baby’s health,” concluded first research writer Mikael Norman, MD, in a Karolinska Institutet press launch.
Apr 29 JAMA study & editorial
Apr 29 Karolinska Institutet
press release


Report particulars uncommon accidents from nasopharyngeal COVID-19 swabbing

Risk of complication from COVID-19 nasopharyngeal swab checks is low (1.24 per 100,000 folks), based on a analysis letter revealed yesterday in JAMA Otolaryngology-Head & Neck Surgery.

The researchers discovered 8 situations amongst 2,899 sufferers admitted to Helsinki University’s otorhinolaryngology emergency division from Mar 1 to Sep 30, 2020; 643,284 reverse transcription-polymerase chain response checks occurred throughout this time. Of the sufferers, seven had been feminine, and imply age was 39.5 years. Four skilled extreme nosebleeds, and 4 had damaged swabs. None had been optimistic for COVID-19.

Healthcare suppliers eliminated the damaged swabs through nasal endoscopy and native anesthesia. The nasal bleeds, nevertheless, required therapy similar to remedy, nasal packing, or surgical and endovascular procedures. Outcomes of nosebleeds included one occasion of sepsis, three native infections, and blood transfusions in three sufferers. Two of the nostril bleeds resulted in life-threatening hemoglobin ranges falling beneath 6.5 grams per deciliter.

“All complications seemed to involve an incorrect sampling technique: excess use of force or an overly cranial direction of the swab,” write the researchers. “Based on the results, the risk for a severe complication requiring specialist-level care after SARS-CoV-2 nasopharyngeal swab testing is extremely low.”
Apr 29 JAMA Otololaryngol Head Neck Surg study


Flu vaccine uptake will increase after textual content reminders

Text message “nudges” earlier than main care visits could increase seasonal flu vaccine uptake greater than 10%, a research yesterday in Proceedings of the National Academy of Sciences (PNAS) exhibits.

The discovering was based mostly on 47,306 sufferers in Penn Medicine and Geisinger Health methods who acquired 1 of 19 completely different doable nudges delivered to their cell units throughout the fall of 2020. The sufferers had opted in for textual content message from suppliers, and digital well being information confirmed they’d not but acquired a flu shot.

The sufferers had been focused through textual content earlier than an upcoming medical appointment. The common age was 51, 43% had been male, 70% had been White, and 47% had been vaccinated within the earlier flu season.

The authors stated 6 out of 19 interventions (32%) produced a statistically vital increase in vaccinations. The top-performing nudges advised sufferers a flu vaccine was reserved for them at an upcoming appointment and had been delivered 72 and 24 hours earlier than an appointment.

“The top-performing intervention in our study showed a 4.6 percentage point boost in vaccination (an 11% increase; P < 0.01) at the cost of sending two text messages (less than a dime),” the authors stated. “Although the factors influencing the adoption of vaccines for other diseases, including COVID-19, differ in important ways, this successful script could potentially be repurposed.”
Apr 29 PNAS


Madagascar, Liberia report first vaccine-derived polio instances

Nine international locations reported polio instances this week, all involving vaccine-derived strains, together with the primary in Madagascar and Liberia, based on the most recent replace from the Global Polio Eradication Initiative (GPEI). Of international locations reporting instances, seven are in Africa, and two are within the Middle East and central Asia.

In Africa, Madagascar reported 3 circulating vaccine-derived poliovirus kind 1 (cVDPV1) instances, 2 within the South East area which can be counted in 2020 totals and 1 in South West area that’s the first of 2021. A list of vaccine-derived polio instances from GPEI signifies that they’re the nation’s first such instances.

Meanwhile, Liberia reported its first circulating vaccine-derived poliovirus kind 2 (cVDPV2) case, which entails a affected person from Bong. Also, 5 international locations in Africa reported extra cVDPV2 instances: the Democratic Republic of the Congo (1), Mali (1), Nigeria (2), Sierra Leone (3), and South Sudan.

In the Middle East, Afghanistan reported 1 extra cVDPV2 case, in a affected person from Hirat, bringing the nation’s whole for the 12 months to 33. And close by Tajikistan reported yet one more such case, involving an individual from Khatlon, lifting its whole for 2021 to 6.
Apr 29 GPEI update
table of circulating vaccine-derived polio instances

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