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COVID-19 Update: Statins and Mortality, Value of Imperfect Tests COVID-19 Update: Statins and Mortality, Value of Imperfect Tests

Editor’s note: Find the latest COVID-19 news and guidance in Medscape’s Coronavirus Resource Center.

Here are the coronavirus stories Medscape’s editors around the globe think you need to know about today: 

Statins and Mortality

Treatment with statins was associated with a reduced risk for a severe or fatal course of COVID-19, a meta-analysis of four retrospective studies suggests.

The analysis included nearly 9000 COVID-19 patients, and found a 30% reduced risk for fatal or severe COVID-19 among patients who were users of statins compared with nonusers. The findings “discredited the suggestion of harms with the use of statins in COVID-19 patients,” the authors conclude. 

While they caution that data from prospective studies is necessary to substantiate the results, they also propose that “moderate-to-high intensity statin therapy is likely to be beneficial” for COVID-19 patients.

The Value of Imperfect Tests

When testing for SARS-CoV-2, different questions and settings require different sorts of tests, Harvard epidemiologist William P. Hanage writes in Medscape. To guide treatment in a healthcare setting, for example, clinicians need a very sensitive and specific test. 

But when screening for the virus out in the community, a test that is highly specific but not very sensitive, is cheap and fast enough to be taken daily, would be useful. Such tests exist, but regulators see their lack of sensitivity as a problem because some infected people will get false-negative results. “This is obviously not ideal,” Hanage writes, “but for screening purposes it may not be such a hindrance.” 

Two FDA PR Employees Removed

The US Food and Drug Administration (FDA) has removed two senior public relations employees who advised the agency against unbridled promotion of convalescent blood plasma as a treatment for people with COVID-19, multiple media outlets reported today. 

One of the PR employees, Emily Miller, was on the job less than 2 weeks. The White House named her FDA chief spokeswoman 11 days ago, but FDA Commissioner Stephen Hahn, MD, removed her from that post today. 

Yesterday, the US Department of Health and Human Services terminated the contract for Wayne L. Pines, a PR consultant to the FDA. Pines reportedly advised Hahn to apologize for making misleading claims about the therapeutic benefits of convalescent plasma therapy for COVID-19. 

At the Sunday White House event announcing the FDA’s emergency use authorization for treating COVID-19 patients with convalescent plasma, Hahn incorrectly stated that plasma had been found to save the lives of 35% of patients who were treated, apparently conflating absolute and relative risk reduction. After a firestorm of criticism, Hahn issued an apology earlier this week. 

CDC Testing Guidelines 

Asymptomatic individuals who come into close contact with people suspected or confirmed to have SARS-CoV-2 infection can seek testing, Centers for Disease Control and Prevention (CDC) Director Robert Redfield, MD, said in a statement Thursday in response to concerns that recently revised COVID-19 testing guidelines might result in an increase in disease transmission. 

Initial policy changes made without fanfare earlier this week suggested that testing should be reserved for symptomatic people or vulnerable, asymptomatic populations, unless otherwise directed by a physician or local health authority. However, “testing may be considered for all close contacts of confirmed or probable COVID-19 patients,” Redfield said in yesterday’s statement.

Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases and a key member of the White House Coronavirus Task Force, has said that he was not in the August 20 task force meeting that discussed changing the CDC guidelines. “I was under general anesthesia in the operating room [for surgery on his vocal cords] and was not part of any discussion or deliberation regarding the new testing recommendations,” he told CNN.

Women Have Stronger Immune Response Than Men

Women’s bodies produce a stronger immune response to SARS-CoV-2 than men’s bodies do, a study published Wednesday in the journal Nature found. 

“Female patients mounted significantly more robust T cell activation than male patients during SARS-CoV-2 infection, which was sustained in old age,” the researchers write. “Importantly, we found that a poor T cell response negatively correlated with patients’ age and was associated with worse disease outcome in male patients, but not in female patients.”

More Cases in Children, but Deaths Remain Low

Children represented 9.3% of all US COVID-19 cases as of August 20, 2020 — an increase from 9.1% the previous week — but only 0.06% of all US deaths were reported, according to a report from the American Academy of Pediatrics and the Children’s Hospital Association.

The cumulative number of pediatric cases reported up to that date was 442,785, and 92 have died. Child hospitalizations represent 1.7% (4062) of 234,810 total admissions among all ages, based on data from 21 states and New York City.

In Memoriam

As frontline healthcare workers care for patients with COVID-19, they commit themselves to difficult, draining work and also put themselves at risk for infection. Thousands throughout the world have died.

Medscape has published a memorial list to commemorate them. We will continue updating this list as, sadly, needed. Please help us ensure this list is complete by submitting names with an age, profession or specialty, and location through this form.

If you would like to share any other experiences, stories, or concerns related to the pandemic, please join the conversation here.

Ellie Kincaid is Medscape’s associate managing editor. She has previously written about healthcare for Forbes, the Wall Street Journal, and Nature Medicine. She can be reached at [email protected] or on Twitter @ellie_kincaid .

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