Study finds no transmission of COVID-19 from moms to newborns
A study yesterday in The Lancet Child & Adolescent Health found no evidence of COVID-19 transmission between 120 babies born to mothers with COVID-19, even after 2 weeks of breastfeeding with appropriate hygiene precautions.
The findings led the American Academy of Pediatrics (AAP) to change its guidance on infants and COVID-19–positive mothers. The guidelines now recommend that newborns "room-in" with infected others after delivery if proper hygiene precautions are taken, including wearing a mask when appropriate and practicing hand hygiene.
The small observational study was based on 120 babies born to 116 mothers at three hospitals in New York City, between Mar 22 and May 17. The babies were kept in enclosed cribs in their mothers' hospital rooms, and mothers wore surgical masks while handling their babies and followed frequent hand and breast washing procedures.
None of the babies tested positive for COVID-19 24 hours after birth. Follow-up at 5 to 7 days post-birth and through the first month of life showed no infections.
In a commentary on the study, Melissa Medvedev, MD, of the University of California San Francisco, said the authors of the study "provide valuable data indicating that perinatal SARS-CoV-2 transmission is unlikely, and allowing newborns to room-in and breastfeed is safe, with appropriate precautions." But Medvedev cautioned more studies are needed to quantify the incidence of complications among pregnant women and newborns.
Jul 23 Lancet Child Adolesc Health study
Jul 22 AAP guidance
Jul 23 Lancet Child Adolesc Health commentary
Study finds higher COVID-19 diagnoses, deaths in counties with more Latinos
COVID-19 diagnosis rates are greater in disproportionally Latino counties, but risks and deaths among Latino populations differ by region, US researchers reported yesterday in the Annals of Epidemiology.
For the study, researchers compared predictors of COVID-19 cases and deaths between counties where Latinos made up more than 17.8% of the population and all other US counties through May 11. They also looked at the heterogeneity of the US Latino population and explored whether differences in a set of core demographic variables play a role in COVID-19 diagnoses and deaths.
Their analysis showed that COVID-19 diagnosis rates were greater in disproportionately Latino counties nationally (90.9 vs 82.0 per 100,000 population), and that COVID-19 diagnoses and deaths increased with the proportion of Latinos living within a given county, particularly in the Midwest and Northeast. In a multivariable analysis that adjusted for other predictors of COVID-19, the adjusted rate ratio [aRR] for Latino counties in the Northeast was 1.42 (95% confidence interval [CI], 1.11 to 1.84) and 1.70 (95% CI, 1.57 to 1.85) for Latino counties in the Midwest. COVID-19 deaths were higher in Midwestern Latino communities (aRR, 1.17; 95% CI, 1.04 to 1.34).
The analysis also found that higher rates of COVID-19 cases were associated with a greater proportion of monolingual Spanish speakers (aRR, 1.28; 95% CI, 1.16 to 1.42), higher heart disease death rates (aRR, 1.o7; 95% CI, 1.o1 to 1.14), less physical distancing (aRR, 0.72; 95% CI, 0.64 to 0.81), and more days since the first case was diagnosed (aRR, 1.90; 95% CI, 1.80 to 2.01). COVID-19 deaths were associated with crowded living conditions (aRR, 1.13; 95% CI, 1.04 to 1.22) and elevated air pollution (aRR, 1.23; 95% CI, 1.03 to 1.47).
The authors suggested the higher death rate in Latino Midwest counties could be linked to Midwestern meat and poultry processing facilities, which employ many Latino migrants. They say the findings call for "focused and energetic" policy responses.
"Our analyses provide a timely proxy for assessing the impact of COVID-19 on Latino communities and affirm the importance of Latino tailored prevention, care, and focused efforts to meet the needs of Latino individuals and communities," they wrote.
Jul 23 Ann Intern Med study
Pilot study evaluates use of dogs for SARS-CoV-2 detection
A small pilot study suggests trained scent-detection dogs have the potential to be used for mass detection of people infected with SARS-CoV-2, the virus that causes COVID-19, German researchers reported yesterday in BMC Infectious Diseases.
In the study, eight dogs were trained for 1 week to detect SARS-CoV-2 from saliva or tracheobronchial secretions of patients infected with the virus. During the training, dogs were presented with positive and negative samples (confirmed by RT-PCR tests) using a device with seven scent holes with tubes leading to metal containers that held the samples. Only one hole had a container with a positive sample, and the other six had containers with control samples. After a week, the researchers conducted a double-blind, randomized controlled trial.
During the presentation of 1,012 randomized samples, the dogs achieved an overall detection rate of 94% (plus or minus 3.4%), with 157 correct indications of a positive sample, 792 correct rejections of a negative sample, and 33 false-positive and 30 false-negative indications. The dogs discriminated between infected and non-infected people with an overall diagnostic sensitivity of 82.63% (95% CI, 82.02% to 83.24%) and specificity of 96.35% (95% CI, 96.31% to 96.39%). There was no noticeable difference in detection ability between saliva and tracheobronchial secretions.
The authors of the study note several limitations, including the fact that the positive samples were from patients with severe COVID-19. They say future research should focus on samples from mild, pre-symptomatic, and asymptomatic patients. In addition, the samples were inactivated, and because it's still unclear whether dogs can spread the virus to humans, using them for testing in the field could be problematic. The authors say they are developing strategies for secure presentation of non-inactivated samples.
"Further work is necessary to better understand the potential and limitation of using scent dogs for the detection of viral respiratory diseases," they wrote.
Jul 23 BMC Infect Dis study