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CIDRAP COVID-19 SCAN - COVID-19 and strokes; Telework lowers COVID risk

Shiloh

Editor, Senior Moderator
Source: https://www.cidrap.umn.edu/news-perspective/2020/11/covid-19-scan-nov-06-2020


COVID-19 Scan for Nov 06, 2020
COVID-19 and strokes; Telework lowers COVID risk
Filed Under:
COVID-19



Study finds greater severity, disability in COVID-19 strokes

A University College London (UCL) and UCL Hospital study this week found that COVID-19–associated ischemic strokes—caused by an obstruction of blood vessels in the brain—are more severe and more likely to result in disability or death than non-COVID strokes are, and Asian people are especially hard-hit.
Researchers in the Journal of Neurology, Neurosurgery & Psychiatry studied 86 COVID-19–positive stroke patients admitted to 13 hospitals in England and Scotland from Mar 9 to Jul 5, comparing stroke severity and outcomes with 1,384 COVID-19–negative stroke patients admitted during the same period.
Strokes were more likely to be severe in infected patients (severity score 8 vs 5, P < 0.002), and stroke patients were only half as likely to leave the hospital without disability as those without COVID-19 (median disability score 4 vs 3, P < 0.0001). COVID-19 stroke patients also had significantly higher rates of in-hospital mortality (19.8% inpatient death vs 9.6%, P < 0.0001).
COVID-19–related strokes were twice as likely to be caused by blockage of more than one large blood vessel in the brain (17.9% vs 8.1%, P< 0.03), suggesting abnormal blood clotting. Infected patients had higher levels of D-dimers (P < 0.01)—a protein marker for blood stickiness that may explain greater stroke severity and poorer outcomes.
"Some of the differences relate to what other studies are uncovering about COVID-19, in that it might make blood stickier and more likely to clot," lead researcher Richard Perry, MD, PhD, of UCL and UCL Hospital said in a college press release.
The researchers found that Asian people were overrepresented—nearly 1 in 5—in the COVID-19 stroke group (18.8% vs 6.7%, P < 0.0002). "Our study suggests that COVID-19 has had more impact on strokes in the Asian community than in other ethnic groups," Perry said in the UCL release. "We cannot say from our data whether this is because people of Asian descent are more likely to catch COVID-19, or whether Asian patients with COVID-19 are more likely to have ischaemic strokes, or both."
Nov 3 J Neurol Neurosurg Psychiatry study
Nov 5 UCL news release
Nov 5 BMJ news release

Health benefits, socioeconomic differences in telework access

New data from the Centers for Disease Control and Prevention (CDC) and their state partners today show that the ability to telework reduces the risk of contracting SARS-CoV-2, the virus that causes COVID-19. The data highlight socioeconomic differences in access to telework, and the need for increased worker safety measures in industries for which telework options are not available.
The multistate study in today's Morbidity and Mortality Weekly Report (MMWR) examined 314 symptomatic adults who sought COVID-19 testing at outpatient testing or healthcare centers from Jul 1 to Jul 29, of whom 153 (49%) were SARS-CoV-2–positive. Participants reported their telework status for the 2 weeks preceding illness onset, with the percentage who reported teleworking on a full- or part-time basis significantly lower among infected patients (35%) than among control participants (53%).
Participants who reported teleworking were more likely to be non-Hispanic white (P < 0.01), have a college degree or higher (P < 0.01), have health insurance (P < 0.01), earn an income of $75,000 (P < 0.01), and report close contact with a person with a known COVID-19 case (P = 0.03). No significant differences were noted in most community exposures, but COVID-19–positive participants were more likely to report going to an office or school setting in the two weeks prior to illness onset (odds ratio, 1.8; 95% confidence interval, 1.2 to 2.7).
"Providing the option to work from home or telework when possible, is an important consideration for reducing the risk for SARS-CoV-2 infection," the study authors write. "In industries where telework options are not available, worker safety measures should continue to be scaled up to reduce possible worksite exposures."
Nov 6 MMWR study
 
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