Women, men and COVID-19.

BACKGROUND: There is often gender bias in access and provision of care. Women fall through the cracks of the healthcare system due to gender-biased norms and poorer socioeconomic status. METHODS: This study uses COVID-19 sex-disaggregated data from 133 countries. Using bootstrapping and imputation methods and heteroscedastic linear regression model, it investigates the effect of biological factors and gender norms on reported differences in male and female COVID-19 case and death rates. RESULTS: Gender norms are significant factors explaining such differences. Countries, where women experience more discrimination in families and have less access to resources, education and finance, report larger differences between male and female rates of COVID-19 cases and deaths. CONCLUSION: Women's lower access to healthcare due to social norms, financial and non-financial barriers may affect women's testing for COVID-19 and access to adequate care, and result in underreported female cases and deaths from COVID-19.

The use of ultrasound in establishing COVID-19 infection as part of a trauma evaluation.

PURPOSE: The use of lung ultrasound for diagnosis of COVID-19 has emerged during the pandemic as a beneficial diagnostic modality due to its rapid availability, bedside use, and lack of radiation. This study aimed to determine if routine ultrasound (US) imaging of the lungs of trauma patients with COVID-19 infections who undergo extended focused assessment with sonography for trauma (EFAST) correlates with computed tomography (CT) imaging and X-ray findings, as previously reported in other populations. METHODS: This was a prospective, observational feasibility study performed at two level 1 trauma centers. US, CT, and X-ray imaging were retrospectively reviewed by a surgical trainee and a board-certified radiologist to determine any correlation of imaging findings in patients with active COVID-19 infection. RESULTS: There were 53 patients with lung US images from EFAST available for evaluation and COVID-19 testing. The overall COVID-19 positivity rate was 7.5%. COVID-19 infection was accurately identified by one patient on US by the trainee, but there was a 15.1% false-positive rate for infection based on the radiologist examination. CONCLUSIONS: Evaluation of the lung during EFAST cannot be used in the trauma setting to identify patients with active COVID-19 infection or to stratify patients as high or low risk of infection. This is likely due to differences in lung imaging technique and the presence of concomitant thoracic injury.