COVID-19: Testing During Pregnancy / Protection After Infection? / ACE2 Expression in Kids' Noses / Alcohol Harms

By Amy Orciari Herman

Edited by Susan Sadoughi, MD, and Richard Saitz, MD, MPH, FACP, DFASAM

Here's a quick look at some of the latest findings on novel coronavirus disease (COVID-19):

Testing during pregnancy: In areas with high COVID-19 prevalence, asymptomatic infection is common among pregnant women and the family or friends (i.e., support people) who accompany them into the delivery room, researchers report in Obstetrics & Gynecology. Roughly 160 pregnant women with scheduled deliveries (e.g., cesarean, labor induction) at a New York City hospital in early April first underwent telephone screening for COVID-19 symptoms and then underwent SARS-CoV-2 testing the day before delivery. None screened positive, yet 16% had positive test results. Additionally, of the support people who screened negative by phone, nearly 10% tested positive the day before delivery. The researchers write, "If universal testing of pregnant patients in a high prevalence area is not performed, health care workers will be inadvertently exposed to COVID-19, unless universal precautions with personal protective equipment are taken."

Protection against reinfection: A study performed in macaques, published in Science, suggests that infection with SARS-CoV-2 offers protection against reinfection. Researchers inoculated nine adult rhesus macaques intranasally or intratracheally with SARS-CoV-2. Some 35 days later, after the macaques had cleared the virus, they were rechallenged with the same dose of virus. Little to no viral RNA was subsequently detected in the rechallenged macaques, and all demonstrated anamnestic immune responses.

ACE2 gene expression in kids' noses: ACE2 gene expression in the nasal epithelium is lowest in children younger than 10 years old and then increases with age, according to findings in JAMA. The researchers — noting that ACE2 is the receptor that SARS-CoV-2 uses to enter host cells — write, "Lower ACE2 expression in children relative to adults may help explain why COVID-19 is less prevalent in children." Their findings were based on a retrospective analysis of ACE2 expression in nasal epithelium samples taken from roughly 300 patients in a New York City health system in 2015-2018.

Alcohol & COVID-19: In mid-March, alcohol sales in the U.K. were up 67% — while supermarket sales rose just 43%, experts note in The BMJ. They continue: "Now, as signs emerge of some control over new cases of COVID-19, it is increasingly clear that if we don't prepare for emerging from the pandemic, we will see the toll of increased alcohol harm for a generation." They add that people with alcohol use disorder — and those close to it — before the pandemic took hold are in particular need of attention, and they urge the health system to be prepared for a "surge ... in the need for alcohol treatment services."