Covid19-Sources

COVID-19 is a serious threat to human health and development. The acute burden of the pandemic includes more than 18.2 million deaths worldwide, and is unprecedented in modern times. This represents only a fraction of the total burden, as it excludes infection sequelae. An effective global strategic paradigm has been missing throughout the pandemic. The ‘flattening the curve’ approach neglected the importance of infection sequelae, and being centered on healthcare capacity was conceptually contrary to a people-centered health system. In March 2022, the World Health Organization revised its pandemic approach, importantly shifting emphasis away from managing transmission and towards prevention. Despite limitations, this now recognizes the role of infection sequelae, whose impact is becoming clearer in both variety and scale. Drawing on the foundational concepts of Sun Tzu and Carl von Clausewitz, most country approaches do not qualify as strategies, but rather as operational plans. They are also largely ineffective, neglecting infection sequelae, viral evolution dangers and other parameters. The purpose of this article is to summarize the evidence on COVID-19 infection sequelae, and alongside other contextual parameters use this to motivate that infection should be prevented. This is then used to answer the question: What is an effective strategy against COVID-19?

MASTER THREAD 🧵Immune Dysregulation / Dysfunction Post-CovidFor your reference - all the important papers on post-Covid immune dysregulation in one convenient thread. To be shared liberally with anyone who dares to even whisper the ridiculous notion of immunity debt.— Raffy Flynn (@RaffyFlynnArt) December 11, 2022

Clinical Research in Cardiology - Cases of myocarditis, diagnosed clinically by laboratory tests and imaging have been described in the context of mRNA-based anti-SARS-CoV-2 vaccination....

Nature Medicine - A new analysis using US Department of Veterans Affairs databases showed that reinfection is associated with increased risk of all-cause mortality, hospitalization and a wide range...

Recent evidence indicates that a large proportion of deaths from coronavirus disease 2019 (COVID-19) can be attributed to cardiovascular disease, including acute myocardial infarction, arrhythmias and heart failure. Indeed, severe infection increases the risk of heart failure among patients with COVID-19. In most patients, heart failure arises from complex interactions between pre-existing conditions, cardiac injury, renin-angiotensin system activation, and the effects of systemic inflammation on the cardiovascular system. In this review, we summarize current knowledge regarding pathogen-driven heart failure occurring during treatment for COVID-19, the potential effects of commonly used cardiovascular and anti-infective drugs in these patients, and possible directions for establishing a theoretical basis for clinical treatment.

Ein sicheres Verfahren zum Nachweis einer frühen SARS-CoV-2-Infektion ist der RT-PCR (Reverse Transkriptase-Polymerase-Kettenreaktion)-Test. Das Beispiel einer symptomfreien Patientin mit fünf PCR-Tests in knapp drei Wochen, von denen ausschließlich der mittlere positiv ausfiel, zeigt jedoch, dass man auch mit falsch-positiven Ergebnissen rechnen muss.

"Thromboembolism (TE) rates of COVID-19 are high and associated with higher risk of death. Robust evidence from ongoing clinical trials is needed to determine the impact of thromboprophylaxis on TE and mortality risk of COVID-19."—2020. Still waiting?https://t.co/M7railWlMe— Dr Elisa Perego (@elisaperego78) December 1, 2022

#LongCovid bei KindernEine Zusammenfassung von Studien und Meldungen:Klinische Merkmale, Aktivitätsniveaus und psychische Gesundheitsprobleme bei #Kindern mit LongCovid— Bert Weingarten (@WeingartenDE) March 12, 2021

Key Points. BNT162b2 induces release of exosomes carrying SARS-CoV-2 spike protein.Abs to SARS-CoV-2 develop after detection of circulatory exosomes.Exosomes wi

Cases, data, and surveillance to track and analyze COVID-19.

The Impact of Long COVID on Health, Society, and Economies A World Health Network Virtual Symposium Join us for our long COVID symposium! This global event brings together clinicians, researchers and patients to explore the latest advances in long COVID research and the impacts on health, society, and economies. With every passing day, we find more evidence that getting infected, or reinfected by COVID leads to the risk of chronic disease, long-term disability, and increased risk of heart attacks, strokes, brain damage, and impairment of the immune system. We see a worsening impact on families, communities, the workforce, and the economy. This symposium will cover key aspects of long COVID and the latest research findings, including: What is long COVID? What does it mean to live with it? How does it manifest? What are the underlying disease mechanisms? What can we do if we have long COVID? How can we protect ourselves?

Nature Communications - This Comment piece summarises current challenges regarding routine vaccine uptake in the context of the COVID-19 pandemic and provides recommendations on how to increase...

SARS-CoV-2 causes profound changes in the sense of smell, including total smell loss. Although these alterations are often transient, many patients with COVID-19 exhibit olfactory dysfunction that lasts months to years. Although animal and human autopsy studies have suggested mechanisms driving acute anosmia, it remains unclear how SARS-CoV-2 causes persistent smell loss in a subset of patients. To address this question, we analyzed olfactory epithelial samples collected from 24 biopsies, including from nine patients with objectively quantified long-term smell loss after COVID-19. This biopsy-based approach revealed a diffuse infiltrate of T cells expressing interferon-γ and a shift in myeloid cell population composition, including enrichment of CD207+ dendritic cells and depletion of anti-inflammatory M2 macrophages. Despite the absence of detectable SARS-CoV-2 RNA or protein, gene expression in the barrier supporting cells of the olfactory epithelium, termed sustentacular cells, appeared to reflect a response to ongoing inflammatory signaling, which was accompanied by a reduction in the number of olfactory sensory neurons relative to olfactory epithelial sustentacular cells. These findings indicate that T cell–mediated inflammation persists in the olfactory epithelium long after SARS-CoV-2 has been eliminated from the tissue, suggesting a mechanism for long-term post–COVID-19 smell loss.

Correspondence from The New England Journal of Medicine — Neutralization against BA.2.75.2, BQ.1.1, and XBB from mRNA Bivalent Booster

As the government drops its restrictions, it not only needs to convince people that the virus is nothing to fear, but also that inoculations are essential.

Im Jahr 2021 sind in Deutschland nach endgültigen Ergebnissen der Todesursachenstatistik insgesamt 1 023 687 Menschen verstorben, davon waren 515 559 Männer und 508 128 Frauen. Wie das Statistische Bundesamt (Destatis) weiter mitteilt, stieg die Zahl der Todesfälle damit um 3,9 % gegenüber dem Vorjahr (2020: 985 572 Verstorbene). An COVID-19 als Grundleiden verstarben im Jahr 2021 in Deutschland insgesamt 71 331 Menschen, das waren 79 % mehr als im Vorjahr (2020: 39 758). Damit war COVID-19 bei 7,0 % aller Verstorbenen die ausschlaggebende Todesursache.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19 pneumonia. We hypothesize that SARS-CoV-2 causes alveolar injury and hypo…

The durability of vaccine-mediated immunity to SARS-CoV-2, the durations to breakthrough infection, and the optimal timings of booster vaccination are crucial knowledge for pandemic response. Here, we applied comparative evolutionary analyses to estimate the durability of immunity and the likelihood of breakthrough infections over time following vaccination by BNT162b2 (Pfizer-BioNTech), mRNA-1273 (Moderna), ChAdOx1 (Oxford-AstraZeneca), and Ad26.COV2.S (Johnson & Johnson/Janssen). We evaluated anti-Spike (S) immunoglobulin G (IgG) antibody levels elicited by each vaccine relative to natural infection. We estimated typical trajectories of waning and corresponding infection probabilities, providing the distribution of times to breakthrough infection for each vaccine under endemic conditions. Peak antibody levels elicited by messenger RNA (mRNA) vaccines mRNA-1273 and BNT1262b2 exceeded that of natural infection and are expected to typically yield more durable protection against breakthrough infections (median 29.6 mo; 5 to 95% quantiles 10.9 mo to 7.9 y) than natural infection (median 21.5 mo; 5 to 95% quantiles 3.5 mo to 7.1 y). Relative to mRNA-1273 and BNT1262b2, viral vector vaccines ChAdOx1 and Ad26.COV2.S exhibit similar peak anti-S IgG antibody responses to that from natural infection and are projected to yield lower, shorter-term protection against breakthrough infection (median 22.4 mo and 5 to 95% quantiles 4.3 mo to 7.2 y; and median 20.5 mo and 5 to 95% quantiles 2.6 mo to 7.0 y; respectively). These results leverage the tools from evolutionary biology to provide a quantitative basis for otherwise unknown parameters that are fundamental to public health policy decision-making.

Nature - Msemburi et al. describe how the World Health Organization has estimated the excess mortality associated with the COVID-19 pandemic, by month and for 2020 and 2021, and analyse their...

Early on during a pandemic, vaccine availability is limited, requiring prioritisation of different population groups. Evaluating vaccine allocation is therefore a crucial element of pandemics...

The decline in nasal IgA responses 9 months after infection and minimal impact of subsequent vaccination may explain the lack of long-lasting nasal defence against reinfection and the limited effects of vaccination on transmission. These findings highlight the need to develop vaccines that enhance nasal immunity.

Background The current respiratory viral season in Ontario started early with an intensity experienced throughout the pediatric health system. We sought to examine trends in patient volumes and level of care intensity among children admitted with laboratory-confirmed respiratory viral infection over the last five years in Ottawa. Methods This was a retrospective cohort study of patients at CHEO, a pediatric health centre in Ottawa, who were diagnosed with a laboratory-confirmed respiratory viral infection in the first 72 hours of admission between October 22, 2017 and December 10, 2022. Their admissions were stratified by age groups and levels of care intensity and evaluated for trends over six surveillance periods that begin in Week 35 and end in Week 34 of the following calendar year. Results During this current surveillance period, there was an early, rapid, two-fold increase in admissions due to respiratory viral infections compared to previous periods, driven largely by RSV and influenza. While there were similar age distributions, there was a larger volume of Level 2 and 3 admissions, and higher proportion of patients requiring Level 2 intensity of care (20.8% versus 2.2% to 12.0% in pre-pandemic years; p

Scientists predict China will see the largest COVID surge of the pandemic this winter, with hundreds of millions of people infected. But some experts say that it could have been even worse.

COVID-19 (SARS-CoV-2) has been linked to organ damage in humans since its worldwide outbreak. It can also induce severe sperm damage, according to research conducted at numerous clinical institutions, however the exact mechanism of damage is still unknown. In this study, we downloaded testicular bulk-RNA-seq data from three COVID-19 patients and three uninfected controls from GEO to evaluate the effect of COVID-19 infection on spermatogenesis. By detecting the relative expression of each pathway and the correlation between genes or pathways, we found that COVID-19 could induce testicular cell senescence through MAPK signaling pathway. Cellular senescence was synergistic with MAPK pathway, which further affected the normal synthesis of cholesterol and androgen, inhibited the normal synthesis of lactate and pyruvate, and ultimately affected spermatogenesis. The medications targeting MAPK signaling pathway, especially MAPK1 and MAPK14, are expected to be effective therapeutic medications for reducing COVID-19 damage to spermatogenesis. These result give us a new understanding of how COVID-19 inhibits spermatogenesis and provide a possible solution to alleviate this damage.

BioNanoScience - In recovered COVID-19 patients, the state of mucosal immunity remains understudied. Cytological, functional, and metabolic characteristics of neutrophils and the interleukin status...

The first-generation COVID-19 vaccines have been effective in mitigating severe illness and hospitalization, but recurring waves of infections are associated with the emergence of SARS-CoV-2 variants that display progressive abilities to evade antibodies, leading to diminished vaccine effectiveness. The lack of clarity on the extent to which vaccine-elicited mucosal or systemic memory T cells protect against such antibody-evasive SARS-CoV-2 variants remains a critical knowledge gap in our quest for broadly protective vaccines. Using adjuvanted spike protein–based vaccines that elicit potent T cell responses, we assessed whether systemic or lung-resident CD4 and CD8 T cells protected against SARS-CoV-2 variants in the presence or absence of virus-neutralizing antibodies. We found that 1) mucosal or parenteral immunization led to effective viral control and protected against lung pathology with or without neutralizing antibodies, 2) protection afforded by mucosal memory CD8 T cells was largely redundant in the presence of antibodies that effectively neutralized the challenge virus, and 3) “unhelped” mucosal memory CD8 T cells provided no protection against the homologous SARS-CoV-2 without CD4 T cells and neutralizing antibodies. Significantly, however, in the absence of detectable virus-neutralizing antibodies, systemic or lung-resident memory CD4 and “helped” CD8 T cells provided effective protection against the relatively antibody-resistant B1.351 (β) variant, without lung immunopathology. Thus, induction of systemic and mucosal memory T cells directed against conserved epitopes might be an effective strategy to protect against SARS-CoV-2 variants that evade neutralizing antibodies. Mechanistic insights from this work have significant implications in the development of T cell–targeted immunomodulation or broadly protective SARS-CoV-2 vaccines.

The WHO COVID-19 Clinical management: living guidance contains the Organization’s most up-to-date recommendations for the clinical management of people with COVID-19.

Nature Aging - Mavrikaki et al. show that severe COVID-19 is associated with molecular signatures of aging and low cognitive performance in the human frontal cortex; and emphasize the value of...

Transcriptomic analyses of acute phase whole blood from a large cohort of patients with COVID-19 identify molecular determinants of post-infection long-term sequelae.

It really is a remarkable achievement and maybe a lot of luck that the world mundanely operates with such a complex indicator as life expectancy. Unlike many statistics and quantities of general use that are being monitored and reported regularly...