Do Large Ears Have an Advantage in Preventing Airborne Transmission?

Although double masking provides better protection against COVID-19 than single masking, the exact number of masks needed to achieve the most significant protection has not been determined to date. The present study investigated the changes in leakage with the use of surgical masks in a healthy person in terms of the number of masks. When the number of masks reached the upper limit that could be worn on the ears, large plastic ear attachments were used for each ear. The leakage rate related to the use of a single mask was approximately 50%, and with two masks, it was significantly reduced to approximately 30%. However, the leakage rate increased to approximately 45% with the use of three and four masks. When more than four masks were worn, the rate gradually decreased. Conversely, the rate for three-seven masks was not significantly lower than that for two masks. Although individuals with large ears might be able to wear more than five masks, the use of more than two masks would not be significantly better than the use of two masks.

Marital status and post-COVID-19 conditions.

Although studies have investigated the factors associated with psychological post-COVID-19 symptoms, the impact of marital status on symptom development has not been fully determined. This study conducts a questionnaire survey to investigate the association between marital status and the proportion of patients with post-COVID-19 symptoms in 749 cases as valid responses. Depressive state and memory impairment were more frequently seen in the no-spouse group when each symptom was compared according to marital status. Particularly in individuals in the 40s who had minor COVID-19 illness, this trend was noted. Single patients with mild COVID-19 illness may need proactive psychological support.

Do Large Ears Have an Advantage in Preventing Airborne Transmission?

Although double masking provides better protection against COVID-19 than single masking, the exact number of masks needed to achieve the most significant protection has not been determined to date. The present study investigated the changes in leakage with the use of surgical masks in a healthy person in terms of the number of masks. When the number of masks reached the upper limit that could be worn on the ears, large plastic ear attachments were used for each ear. The leakage rate related to the use of a single mask was approximately 50%, and with two masks, it was significantly reduced to approximately 30%. However, the leakage rate increased to approximately 45% with the use of three and four masks. When more than four masks were worn, the rate gradually decreased. Conversely, the rate for three-seven masks was not significantly lower than that for two masks. Although individuals with large ears might be able to wear more than five masks, the use of more than two masks would not be significantly better than the use of two masks.

Re-expansion pulmonary edema following a pneumothorax drainage in a patient with COVID-19.

BACKGROUND: Re-expansion pulmonary edema is an uncommon complication following drainage of a pneumothorax or pleural effusion. While pneumothorax is noted to complicate COVID-19 patients, no case of COVID-19 developing re-expansion pulmonary edema has been reported. CASE REPRESENTATION: A man in his early 40 s without a smoking history and underlying pulmonary diseases suddenly complained of left chest pain with dyspnea 1 day after being diagnosed with COVID-19. Chest X-ray revealed pneumothorax in the left lung field, and a chest tube was inserted into the intrathoracic space without negative pressure 9 h after the onset of chest pain, resulting in the disappearance of respiratory symptoms; however, 2 h thereafter, dyspnea recurred with lower oxygenation status. Chest X-ray revealed improvement of collapse but extensive infiltration in the expanded lung. Therefore, the patient was diagnosed with re-expansion pulmonary edema, and his dyspnea and oxygenation status gradually improved without any intervention, such as steroid administration. Abnormal lung images also gradually improved within several days. CONCLUSIONS: This case highlights the rare presentation of re-expansion pulmonary edema following pneumothorax drainage in a patient with COVID-19, which recovered without requiring treatment for viral pneumonia. Differentiating re-expansion pulmonary edema from viral pneumonia is crucial to prevent unnecessary medication for COVID-19 pneumonia and pneumothorax.

A systematic review of corticosteroid treatment for noncritically ill patients with COVID-19.

The World Health Organization (WHO) has published guidance recommending systemic corticosteroids for the treatment of patients with severe or critical COVID-19 and no corticosteroids for those with nonsevere COVID-19. Although their recommendations for critical cases were based on the results from seven randomized controlled trials (RCTs), those for noncritical cases were based on the results from only one RCT, the Randomized Evaluation of COVID-19 Therapy (RECOVERY) trial. In search of additional evidence of corticosteroids' effect on COVID-19, we systematically reviewed controlled observational studies, besides RCTs, that assessed the impact of corticosteroid treatment on any type of mortality and/or other outcomes in noncritical patients. Of the 4037 titles and abstracts screened, we ultimately included the RECOVERY trial and five controlled observational studies using propensity score matching, (accessed on September 8, 2020). Two of the controlled observational studies assessed the association between corticosteroid treatment and in-hospital mortality, without finding statistical significance. Four of the controlled observational studies assessed corticosteroids' effect on other outcomes, demonstrating that they were associated with reduced risk of intubation in patients requiring oxygen and with longer hospitalization and viral shedding in mild or moderate cases. These results support the WHO recommendations not to use corticosteroids for nonsevere COVID-19.

COVID-19 pandemic and the incidence of community-acquired pneumonia in elderly people.

The impact of the COVID-19 pandemic on the incidence of community-acquired pneumonia in elderly people remains uncertain. We compared the number of elderly patients admitted to our hospital for community-acquired pneumonia from January to June 2020 to the numbers from the same period in each of the last three years. The number of patients began decreasing in February 2020, and by April 2020 the number was significantly lower than those from the same period in the three years prior. There is no evidence regarding the impact of general infection control measures, such as wearing a face mask or washing one's hands, on the development of community-acquired pneumonia, because causative bacteria are not believed to be transmitted from human to human. However, these measures might have indirectly contributed to a decreased number of cases through the prevention of common viral infections which could be a trigger of community-acquired pneumonia.