COVID-19: New WHO Guidance / ARDS Risk Factors / Mass Gatherings

By Kelly Young

Edited by Susan Sadoughi, MD, and André Sofair, MD, MPH

Over 3000 cases of coronavirus disease (COVID-19) have been reported in the U.S., while the global count is over 150,000. The U.S. reports roughly 60 deaths. This is a rapidly changing situation, so we've gathered some of the most clinically relevant material from the past few days:

• The World Health Organization has updated its interim clinical guidance for severe acute respiratory infection when COVID-19 is suspected. It covers best practices for infection prevention and control, triage, and management of illness.

• Among 200 patients hospitalized with COVID-19 in Wuhan, China, factors that increased the risk for developing acute respiratory distress syndrome (ARDS) and for dying include older age, neutrophilia, and higher lactate dehydrogenase and D-dimer levels, according to a JAMA Internal Medicine study. Among patients with ARDS, methylprednisolone was associated with lower risk for death.

• The CDC now recommends that people postpone or cancel mass gatherings of 50 or more people for the next 8 weeks. This specific guidance doesn't apply to schools or businesses.

• Officials from Kaiser Permanente propose a shift from containment to mitigation in the U.S. "COVID-19 containment is no longer realistic and further emphasis on containment strategies may have the unintended consequence of hampering effective health care delivery for patients infected with COVID-19 and others who require general hospital care," they write. They outline key elements of their company's mitigation strategy in JAMA.

• The FDA has cleared several commercial and state tests for SARS-CoV-2, the virus that causes COVID-19.