Becker's Clinical Quality & Infection Control

7 INFECTION CONTROL 3 factors that may boost COVID-19 patients' death risk By Mackenzie Bean O ld age, signs of sepsis and blood clotting issues may put hospitalized COVID-19 patients at greater risk of death, according to a study published March 9 in The Lancet. For the study, researchers analyzed clinical records, treatment data and lab results for 191 adult COVID-19 patients admitted to two hospitals in Wuhan, China, after Dec. 29, 2019. Patients either died or were discharged by Jan. 31. Six study findings: 1. Patients' median age was 56, and 62 percent were men. 2. Forty-eight percent of patients had underlying chronic diseases, the most common being high blood pressure and diabetes. 4. The median time for illness onset to discharge was 22 days, while the average time to death was 18.5 days. 5. The risk of death was higher among patients who were older, had a higher sepsis-related organ failure assess- ment score or had elevated blood coagulation levels. 6. Patients who died were also more likely to experience complications such as respiratory failure, sepsis and sec- ondary infections. Researchers noted their findings may be limited due to the study's small sample size. n Call in the 'e-cavalry': Physicians fight back against online anti-vaccine attacks By Mackenzie Bean P hysicians, nurses and other vaccine advocates are banding together to defend against anti-vaccine attacks online, reported The New York Times. The group of activists, called Shots Heard Round the World, aims to protect clinicians and healthcare orga- nizations that face online harassment when promoting vaccines on their websites or social media pages. The "e-cavalry," as NYT called the group, contains about 600 volunteers worldwide, including physicians, lawyers and state legislative employees. The volunteers commu- nicate about anti-vaccine attacks via email and a closed Facebook group. "We want them to ride to the site and do whatever they feel comfortable doing," Todd Wolynn, MD, CEO of Pittsburgh-based Kids Plus Pediatrics, who helped found the group, told NYT. "For some, it's to respond to every bogus claim with a link to an evidence-based study. For others, it's to push back at the anti-vaxxers." The group also created an 80-page resource called the "Anti-Anti-Vaxx Toolkit," and on March 5 held a large virtual rally pushing pro-vaccine messages with hashtags like #DoctorsSpeakUp, which was retweeted more than 100,000 times. n Viral shedding is high in first days of COVID-19 illness, study shows By Anuja Vaidya P eople who have contracted COVID-19 "shed" the virus most heavily in the first few days of the illiness, and shedding may continue even aer they stop showing symptoms, according to research cited by STAT. e study had not yet been peer-reviewed as of early March, but still may offer valuable information for the prevention and treat- ment of COVID-19. Conducted by German researchers, the study examined nine people with COVID-19. ey studied viral shedding, which occurs when the virus is released from the host. Researchers found viral shedding occurred in high levels from the throat at the earliest points of the illness for all patients, according to STAT. But viral shedding levels dropped aer the fih day in all patients except for the two with more severe cases of COVID-19, who continued to shed the virus from the throat at high levels until the 10th or 11th day. Researchers also tried to grow viruses from sputum (a mixture of saliva and mucus), blood, urine and stool samples taken from the patients, which can help determine how people infect others and the timeframe with- in which infection passes from one person to another. But they could not grow viruses from the throat and sputum samples taken from those with mild illnesses aer eight days of the illness, STAT reported. us, people with mild infections can test positive per throat swabs aer their illness, but they are likely not infectious about 10 days aer they start experiencing symptoms. Researchers contrasted viral shedding of the SARS coronavirus, which occurred later in the timeframe of the illness. COVID-19 is shedding 1,000-plus times more virus than SARS patients emitted during peak shed- ding, according to STAT. n

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