Key health and science updates on the pandemic from around the globe

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The National Health Service (NHS) in England is warning doctors that the pediatric population testing positive for COVID-19 can have presentations similar to toxic shock syndrome and atypical Kawasaki disease. Manifestations such as abdominal pain, other gastrointestinal symptoms and cardiac inflammation have been reported. A disproportionate inflammatory response could be responsible for these symptoms.

Amy Woodyatt and Jacqueline Howard. Coronavirus could be tied to a rare but serious illness in children: U.K. doctors. CTV News. April 27, 2020.

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The COVID-19 crisis has caused a 30% to 40% decrease in ER visits all over Canada, and unfortunately, many patients requiring immediate care are avoiding hospitals because of the risk of contracting the disease. Dr. Gaurav Puri of Southlake Regional Health Centre in Newmarket reported multiple cases of patients delaying visits to hospital. For example, a patient with COPD exacerbation waited 2 weeks before visiting the ER and almost needed a ventilator, and there have been cases of patients who have ruptured appendicitis upon presentation at the ER after a week of abdominal pain. 

Avery Haines, Alexandra Mae Jones. ‘All of our rooms are empty’: Hospital ERs vacant during pandemic. CTV News. April 29, 2020.

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Paediatricians suggest that parents respect the immunization calendar for their children, despite the current crisis. The risk of contracting COVID-19 is limiting the vaccine coverage, and this may cause herd immunity to become weaker.

La Presse. Vaccination des enfants: les parents invités à respecter le calendrier. April 22, 2020.

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A large number of countries have delayed their vaccination programs because of the crisis. Before the pandemic, 86% of children worldwide were vaccinated against measles, a number below the target of 95%. In Canada, 90% of children under the age of 2 have received at least one dose of the vaccine. Immunization calendars should therefore be respected, and a large vaccination campaign should be planned after the pandemic.

La Presse. L’interruption des campagnes de vaccination inquiète l’UNICEF. April 24, 2020.

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At Western University in Ontario, researchers have analyzed the propagation of particles when a person coughs. Eric Savory, Professor at the Faculty of Mechanical and Materials Engineering, concluded that at a 2.5 meter distance, we still find 10% of the droplets emitted.

This research is modelling the physical movement of particles, without taking into account the biology of the virus.

Philippe Mercure. La contagion pourrait se faire au-delà de deux mètres. La Presse. April 23, 2020.

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The Quebec Federation of Alzheimer’s Societies is concerned about cognitive impairment worsening with isolation of elders with Alzheimer’s disease. Interactions with caregivers play an important role in slowing down the progression of the disease. Without sufficient personnel, there are concerns of an increase in anxiety, psychological distress, sleep disturbances and decline of functional and cognitive status. 

Stéphanie Marin. Inquiétudes pour les aînés atteints d’Alzheimer. La Presse. April 17, 2020.

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Doctors at the Sainte-Justine Hospital are confronted with an increase in Kawasaki disease among children, though not all tested positive for COVID-19. This phenomenon has also been reported in other countries around the world.

Janie Gosselin. Corrélation possible entre une maladie inflammatoire infantile et la COVID-19. La Presse. April 29, 2020.

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There is a significant decrease in consultation for myocardial infarctions (MI) and strokes with the pandemic because individuals fear contracting COVID-19 from hospitals. In Canada, admissions for MI have decreased by over 40% and this number reaches 60% in Quebec. Even more alarming, ER visits for strokes have dropped by over 80% in the province.

Since we know that every minute counts in these conditions, patients should be advised to visit the ER without any delay.

Thomas Gerbet. « Bombes à retardement » : des victimes d’infarctus et d’AVC évitent les urgences. April 13, 2020.

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Deep vein thrombosis and pulmonary embolism have been described in many patients affected by COVID-19, including young adults without any risk factors. Many doctors have reported that the coagulation abnormalities were atypical, and that heparin wasn’t working in these patients.

In these situations, amputation may sometimes be the only way to treat ischemia. Also, artificial ventilation can be inefficient with pulmonary embolism because of the shunt created by the blood clots.

Ivan Couronne, Issam Ahmed. Blood Clots: Another Bad Surprise From COVID-19. La Presse. April 27, 2020.

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Alarming cases of large vessel occlusions have been reported among adults in their 30s and 40s. At Mount Sinai Hospital, Manhattan, a 44 year old man, without any pre-existing conditions, was admitted with a severe stroke and no evidence of respiratory symptoms, even though he tested positive for COVID-19.

Dr. Thomas Oxley, vascular and interventional neurologist, noted that the brain imaging of the patient looked “like a can of spaghetti”, something he had never seen before. New clots were forming around the area of the stroke as he was removing the clot.

Ariana Eunjung Cha. Young And Middle-Aged People, Barely Sick With Covid-19, Are Dying Of Strokes. Washington Post. April 25, 2020.

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