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A pitfall in estimating the effective reproductive number Rt for COVID-19

Viewpoint
Petermann M, Wyler D
Swiss Med Wkly. 2020;150:w20307

The effective reproductive number Rt of COVID-19 is determined indirectly from data that are only incompletely known. Approaches based on reconstructing these data by sampling time lags from suitable distributions introduce noise effects that can result in distorted estimates of Rt. This, in turn, may lead to misleading interpretations of the efficacy of the various measures taken to limit COVID-19 transmission.

Unexpected liaisons between old cytokines and new deadly virus

Viewpoint
Beretta A
Swiss Med Wkly. 2020;150:w20315

Researchers in Italy have not only identified new unexpected liaisons between old cytokines and the new coronavirus that open the way to the use in COVID-19 of drugs already approved for other diseases, but they have also provided valuable indications on how to better prepare ourselves to face a possible second wave of infection.

COVID-19 and the role of imaging: early experiences in Central Switzerland

Viewpoint
Fechner C, Strobel K, Treumann T, Sonderegger B, Azzola A, Fornaro J, Schrading S, Roos JE
Swiss Med Wkly. 2020;150:w20304

The authors describe the first clinical experiences with 55 COVID-19 patients in Central Switzerland. They provide an illustrative and schematic description of typical COVID-19 imaging features and suggest that imaging plays an important role in the clinical work-up of suspected or confirmed COVID-19 patients. 

Venous thromboembolism in COVID-19: systematic review of reported risks and current guidelines

Systematic review
Fontana P, Casini A, Robert-Ebadi H, Glauser F, Righini M, Blondon M
Swiss Med Wkly. 2020;150:w20301

Venous thromboembolism very commonly complicates the clinical course of inpatients with COVID-19, despite thromboprophylaxis. The risk appears highest among critically ill inpatients. Many questions remain unresolved, as delineated by the heterogeneity of national and international guidelines.

Oral antibiotic therapy in people who inject drugs (PWID) with bacteraemia

Review article: Biomedical intelligence
Martinez AE, Scheidegger C, Bättig V, Erb S
Swiss Med Wkly. 2020;150:w20259

Treatment of bacteraemia in people who inject drugs remains very complex, and an interdisciplinary approach is essential in order to select the best therapy for this vulnerable group of patients.

Clinical course of COVID-19 pneumonia in a patient undergoing pneumonectomy and pathology findings during the incubation period

Original article
Çınar HU, İnce Ö, Çelik B, Saltabaş F, Özbek M
Swiss Med Wkly. 2020;150:w20302

The case presented here represents an “incidental” sampling of a lung infected with SARS-CoV-2, as a result of surgery for lung cancer at a time when the lung infection did not produce symptoms. This gave the opportunity to examine the pathology of COVID-19 pneumonia during the incubation period.

Parvimonas micra as a rare cause of spondylodiscitis – case series from a single centre

Original article
Durovic A, Eberhard N, Schären S, Widmer AF
Swiss Med Wkly. 2020;150:w20272

Parvimonas micra is a rare cause of spondylodiscitis. Nevertheless, recent dental procedures with subsequent back pain should lead to the consideration of possible anaerobic causes of spondylodiscitis. Heightened awareness of this pathogen and improvements in diagnostic methods might lead to higher detection rates.

Prevalence of tuberculosis in migrant children in Switzerland and relevance of current screening guidelines

Original article
Boukamel M, Fougère Y, Gehri M, Suris JC, Rochat I, Miletto D, Kyrilli S, Fouriki A, Crisinel PA
Swiss Med Wkly. 2020;150:w20253

Screening migrant children ≥5 years of age for tuberculosis could confer a public health benefit even in the absence of other risk factors. The limit of tuberculin skin test positivity could be raised from ≥5 mm to ≥10 mm to decrease the rate of false-positive results.

Assessing the impact of non-pharmaceutical interventions on SARS-CoV-2 transmission in Switzerland

Original article
Lemaitre JC, Perez-Saez J, Azman AS, Rinaldo A, Fellay J
Swiss Med Wkly. 2020;150:w20295

Current estimates of time-varying R0 in Switzerland well below one are promising. However, as of 24 April 2020, at least 96% of the Swiss population remains susceptible to SARS-CoV-2. These results warrant a cautious relaxation of social distance practices and close monitoring of changes in both the basic and effective reproduction numbers.

D-dimer and mortality in COVID-19: a self-fulfilling prophecy or a pathophysiological clue?

Original article
Breakey N, Escher R
Swiss Med Wkly. 2020;150:w20293

The authors present the case of a patient who was diagnosed with a pulmonary thrombotic complication during inpatient care for COVID-19. The haemostasis parameters, including increased levels of von Willebrand factor and factor VIII, point towards a relevant involvement of endothelial cells in patients with severe COVID-19.

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