ABSTRACT
Paget-Schroetter Syndrome (PSS), a subtype of thoracic outlet syndrome, is a rare condition defined as thrombosis of the axillosubclavian vein secondary to anatomical abnormalities or repetitive injury to vessel endothelium from exertion. In the setting of the COVID-19 pandemic, venous thrombosis in COVID-positive patients may be attributed to the well-described hypercoagulability associated with the viral syndrome, increasing the rate of misdiagnosis of PSS and delaying definitive treatment. We report a case of PSS in a 19-year-old male who presented to multiple health care providers with an upper extremity thrombus and was found to be SARS-CoV-2 positive on hospitalization. In his case, his COVID status likely contributed to a delay in diagnosis of Paget- Schroetter syndrome, with the patient missing the window for the standard treatment protocol.
ABSTRACT
OBJECTIVES: The objective of this study was to inform public health practitioners who are designing, adapting and implementing testing and tracing strategies for Coronavirus disease (COVID-19) control. STUDY DESIGN: The study design is monitoring and evaluation of a national public health protection programme. METHODS: All close contacts of laboratory-confirmed cases of COVID-19 identified between the 19th May and 2nd August were included; secondary attack rates and numbers needed to test were estimated. RESULTS: Four thousand five hundred eighty six of 7272 (63%) close contacts of cases were tested with at least one test. The secondary attack rate in close contacts who were tested was 7% (95% Confidence Interval [CI]: 6.3 - 7.8%). At the 'day 0' test, 14.6% (95% CI: 11.6-17.6%) of symptomatic close contacts tested positive compared with 5.2% (95% CI: 4.4-5.9%) of asymptomatic close contacts. CONCLUSIONS: The application of additional symptom-based criteria for testing in this high-incidence population (close contacts) is of limited utility because of the low negative predictive value of absence of symptoms.