By Amy Orciari Herman
Edited by Susan Sadoughi, MD, and Richard Saitz, MD, MPH, FACP, DFASAM
Here are some of the latest developments on novel coronavirus disease (COVID-19):
Early self-proning: Having COVID-19 patients self-prone in the emergency department could help improve oxygen saturation, suggests a study in Academic Emergency Medicine. Fifty patients presenting to a New York City ED with hypoxia (SpO2 <90%) were included. The median SpO2 at triage was 80%, and this increased to 84% after supplemental oxygen (e.g., non-rebreather mask, nasal cannula) was given. Patients were then asked to self-prone (while maintaining supplemental oxygen), and after 5 minutes, the median SpO2 reached 94%. The researchers conclude, “Our experience suggests that the use of rotating or proning is a valuable tool in improving oxygenation and decreasing respiratory effort in many patients with moderate or severe COVID-19.” They offer advice for implementing self-proning at the first link below.
Out-of-hospital cardiac arrest: Cases of out-of-hospital cardiac arrest in northern Italy increased with the rise in COVID-19 cases, researchers report in the New England Journal of Medicine. Some 362 out-of-hospital cardiac arrests were reported across four Italian provinces during the first 40 days of the COVID-19 outbreak, compared with just 229 cases during the same period in 2019. Bystander cardiopulmonary resuscitation was significantly less common during the pandemic. Some 28% of cardiac arrest cases during the pandemic occurred in people who likely had COVID-19; these cases accounted for most of the increase in cardiac arrests.
Breast-feeding guidance: The CDC has issued guidance on breast-feeding during the COVID-19 pandemic. The agency says it does not know whether SARS-CoV-2 can be transmitted through breast milk, but limited data suggest this is not the case. Mothers with suspected or confirmed COVID-19 should take precautions when breast-feeding, including washing their hands first and wearing a cloth face covering. Breast-fed infants of infected mothers “should be considered as having suspected COVID-19 for the purposes of infection control and prevention for the duration of the mother’s recommended period of home isolation and 14 days thereafter.”