COVID-19 Update: Mask Comparisons, Chloroquine Psych Side Effects

Ellie Kincaid

August 11, 2020

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.

Mask Comparisons

N95 masks that are past their expiration date or have been used and resterilized can be acceptable alternatives to standard new single-use N95 masks, new research indicates.

Researchers tested the fitted filtration efficiencies (FFEs) of 29 different fitted face mask alternatives worn by a male and female volunteer who performed a series of repeated movements of the torso, head, and facial muscles to recreate typical occupational activities.

The masks they tested included N95s up to 11 years past their expiration date, N95s that had been sterilized with ethylene oxide and hydrogen peroxide or steam, surgical masks, and respirators that have not been approved by the National Institute for Occupational Safety and Health (NIOSH).

The coauthors of a linked editorial write that despite the apparent "imperfect" FFE of non-NIOSH-approved respirators and surgical masks in the laboratory, "there is reason for optimism regarding their real-world effectiveness."

Chloroquine Linked to Serious Psychiatric Side Effects

Taking chloroquine may be associated with serious psychiatric side effects, even in patients with no family or personal history of psychiatric disorders, suggest researchers who reviewed previously published studies. The review references a study of the FDA's Adverse Event Reporting System database, a clinical trial for malaria prophylaxis, and case reports and series.

"As a rheumatologist who uses hydroxychloroquine at a dose of 400 mg/day, I do not think we need to worry about serious [psychiatric] side effects," Nilanjana Bose, MD, who was not involved in the review, told Medscape Medical News.

"These are potentially very concerning side effects that psychiatrists should be aware of," said another expert.

COVID-19 Cases in US Children Soared in Late July

A new report from the American Academy of Pediatrics and the Children's Hospital Association found that nearly 339,000 children have tested positive for COVID-19 since the onset of the US epidemic. Cases increased by 40% in the last half of July compared to the total reported previously. There were 97,078 new cases.

Most of the new infections occurred in states in the South and West, according to the report, which was based on data from 49 states, New York City, the District of Columbia, Puerto Rico, and Guam.

Residents Ready?

Most residents who were asked whether their training prepared them for COVID-19 in a Medscape survey said it had not or that they weren't sure.

Whereas 40% said they felt prepared, 30% said they did not feel prepared, and 31% answered that they were unsure. The data include answers from 1659 US medical residents.

The Kidney and COVID-19

The rates of acute kidney injury in hospitalized COVID-19 patients has ranged widely in reports on different cohorts, which "points to the idea that we don't fully understand this process and we don't know what is going on or the obvious risk factors," transplant nephrologist Samira Farouk, MD, of Mount Sinai Hospital in New York City, said in a Medscape commentary video.

She and Duke University nephrologist Matthew Sparks, MD, discussed what is known, and what's still mysterious, about how COVID-19 affects patients' kidneys. Whether SARS-CoV-2 directly infects and damages the kidney is "the million-dollar question," said Farouk. "There is compelling evidence on both sides."

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 ekincaid@medscape.net or on Twitter @ellie_kincaid.

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