COVID-19: Positive Tests After Discharge / Surge in Hydroxychloroquine Rx / Cancer / Face Masks at Home

By Kelly Young

Edited by André Sofair, MD, MPH, and William E. Chavey, MD, MS

See some of the latest developments in novel coronavirus disease (COVID-19):

Positive results after discharge: Nearly 16% of 69 patients discharged from a Chinese hospital after recovering from COVID-19 had positive results on real-time reverse-transcriptase polymerase chain reaction (RT-PCR) tests after discharge, according to a study in JAMA Network Open. Positive results occurred between 9 and 17 days after discharge; none of these patients had symptoms at the time of testing.

Surge in hydroxychloroquine prescriptions: In the week that President Donald Trump promoted use of hydroxychloroquine and chloroquine in a press conference, prescriptions for the drugs (less than 28 tablets) surged nearly 2000% compared with the same week the previous year, researchers report in JAMA. In total, there were roughly 500,000 excess fills of hydroxychloroquine/chloroquine from Feb. 16 to Apr. 25, 2020, compared with a similar period in 2019. Separately, a survey by the Lupus Research Alliance found that 36% of some 330 patients with lupus had difficulty filling or could not fill their regular hydroxychloroquine prescriptions during this time.

Cancer and COVID-19: A study in the Lancet looks at 900 adults with COVID-19 who had a current or past diagnosis of invasive or hematologic malignancy. Within 30 days of COVID-19 diagnosis, 13% of patients had died. Cancer that was stable or responding to treatment and progressive disease were each associated with increased mortality risk compared with disease that was in remission. Among these cancer patients, hydroxychloroquine plus azithromycin treatment was tied to nearly triple the mortality risk compared with treatment with neither drug.

Mask wearing at home: Wearing face masks at home may reduce transmission among family members — but only before symptoms develop — a study in BMJ Global Health suggests. Researchers studied roughly 125 families in Beijing in which at least one member contracted COVID-19. Nearly a quarter of household members were subsequently infected. After multivariable adjustment, the risk for secondary transmission was significantly increased when the primary case had diarrhea (odds ratio, 4) and with frequent, daily close contact (within 3 feet) with the primary case at home (OR, 18). Frequent disinfectant use and family members wearing masks at home before the primary case showed symptoms were associated with reduced risk (ORs, 0.2 for both). The authors conclude that the findings "may ... be informative for families of high-risk groups such as health workers, quarantined individuals or situations where cases of COVID-19 have to be managed at home."