COVID-19: Colchicine / Asymptomatic Patients & Environmental Contamination / Bereavement Guidance / Antibody Testing Concerns

By Amy Orciari Herman

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

Check out some of the latest COVID-19 news

Colchicine: The anti-inflammatory agent colchicine might improve outcomes in patients hospitalized with COVID-19, according to a randomized, open-label trial in JAMA Network Open. Some 105 hospitalized patients in Greece were assigned to optimal medical therapy either alone or with colchicine (the drug was given twice daily until hospital discharge, or for no more than 21 days). The clinical primary endpoint — a 2-grade increase on a 7-grade scale indicating clinical deterioration — occurred in 2% of the colchicine group versus 14% of the control group. Cardiac troponin and C-reactive protein levels, meanwhile, did not differ between the groups. The authors and commentators caution that the findings should be considered only hypothesis-generating, given the low enrollment and event rates.

Asymptomatic patients & environmental contamination: Asymptomatic patients with COVID-19 "do contaminate their surroundings and impose risks for others with close contact," researchers report in mSphere. The researchers sampled surfaces in six negative-pressure rooms housing 13 COVID-19 patients in a designated isolation ward in a Chinese hospital. Of 112 surface samples tested (e.g., bed rails, door handles), 39% were positive for SARS-CoV-2, despite all air samples testing negative. In particular, in the room housing a single asymptomatic patient, 4 of 14 samples (29%) tested positive for the virus. Of note, the study did not report whether viral presence on surfaces was related to risk for clinical infection.

Bereavement care guidance: In the Annals of Internal Medicine, bereavement specialists offer guidance for clinicians on communicating condolences to surviving family members of COVID-19 patients. The guidance focuses on communicating compassionately (e.g., use the deceased person's first name), assessing risk for bereavement difficulties (e.g., does the family member have social support?), and making referrals to mental health providers when needed. Linked below, the guidance also offers a sample script clinicians may use when reaching out to family members.

Antibody testing concerns: A group of U.K. physicians and academics voice their concerns about widespread SARS-CoV-2 antibody testing in a letter in The BMJ. The authors emphasize that "a positive result does not indicate immunity." They write, "Those with a positive antibody test should still consider themselves at risk and follow infection control policies designed to prevent nosocomial spread and risk of infection," while adding that "the only current justification for large scale SARS-CoV-2 IgG antibody testing is for research purposes." Read more of their letter, as well as an investigation into SARS-CoV-2 antibody testing, at the links below.