Non-febrile COVID-19 patients were common and often became critically ill: a retrospective multicenter cohort study

What is the rate of COVID-19 infection in a population seeking oral health care?

Background

Although rates of COVID-19 have remained low among US dentists, the authors aimed to determine the risk of there being COVID-19 in patients seeking oral health care.

Methods

The authors performed a retrospective chart review of all emergency department consultations from June 1, 2020, through December 31, 2020. They used Pearson correlation coefficients to compare rates with citywide prevalence (P < .05).

Results

The authors located 203 encounters with 149 tests and 10 cases of COVID-19. Cases were strongly correlated with the citywide positivity rate (r = 0.9147; P = .0039). All patients who tested positive were asymptomatic and afebrile, and one-half (50%) visited a dentist within a week of consultation.

Conclusions

The rate of COVID-19 in a population seeking oral health care reflects the community positivity rate. Asymptomatic or presymptomatic patients pose risks to providers, staff members, and other patients.

Practical Implications

Dentists should remain vigilant during the ongoing COVID-19 pandemic, even with vaccination rollout. The Centers for Disease Control and Prevention maintains an accessible website with easy access to each state’s positivity rate and caseload.

Acute kidney injury in COVID 19 - an update on pathophysiology and management modalities

Acute kidney injury (AKI), characterised by fluid imbalance and overload, is prevalent in severe disease phenotypes of coronavirus disease 2019 (COVID-19). The elderly immunocompromised patients with pre-existing comorbidities being more risk-prone to severe COVID-19, the importance of early diagnosis and intervention in AKI is imperative. Histopathological examination of COVID-19 patients with AKI reveals viral invasion of the renal parenchyma and evidence of AKI. The definitive treatment for AKI includes renal replacement therapy and renal transplant. Immunosuppressant regimens and its interactions with COVID-19 have to be further explored to devise effective treatment strategies in COVID-19 transplant patients. Other supportive strategies for AKI patients include hemodynamic monitoring and maintenance of fluid balance. Antiviral drugs should be meticulously monitored in the management of these high-risk patients. We have focussed on the development of renal injury provoked by the SARS-CoV-2, the varying clinical characteristics, and employment of different management strategies, including renal replacement therapy, alongside the emerging cytokine lowering approaches.