High-dimensional characterization of post-acute sequelae of COVID-19
Nature - Healthcare data from the US Department of Veterans Affairs are used to characterize the six-month incident sequelae of individuals who survive for at least thirty days after developing...
Measles virus infection diminishes preexisting antibodies that offer protection from other pathogens
Many of the deaths attributable to measles virus are caused by secondary infections because the virus infects and functionally impairs immune cells. Whether measles infection causes long-term damage to immune memory has been unclear. This question has become increasingly important given the resurgence in measles epidemics worldwide. Using a blood test called VirScan, Mina et al. comprehensively analyzed the antibody repertoire in children before and after natural infection with measles virus as well as in children before and after measles vaccination. They found that measles infection can greatly diminish previously acquired immune memory, potentially leaving individuals at risk for infection by other pathogens. These adverse effects on the immune system were not seen in vaccinated children.
The Paxlovid Rebound Study: A Prospective Cohort Study to Evaluate Viral and Symptom Rebound Differences Between Paxlovid and Untreated COVID-19 Participants
Introduction: The uptake of Paxlovid in individuals infected with COVID-19 has been significantly limited by concerns around the Paxlovid rebound phenomenon despite the scarcity of evidence around its epidemiology. The purpose of this study was to prospectively compare the epidemiology of Paxlovid rebound in treated and untreated participants with acute COVID-19 infection Methods: We designed a digital, prospective observational study, which included participants who tested positive for COVID-19 and were clinically eligible for Paxlovid. Participants were assigned to a Paxlovid or control group based on their decision to take the medication. Both groups were provided 12 rapid antigen tests and asked to test and answer symptom surveys on a regular frequent schedule for 16 days. Viral rebound based on test results and COVID-19 symptom rebound based on patient reported symptoms were evaluated. Results: Viral rebound incidence was 14.2% in the Paxlovid group (n=127) and 9.3% in the control group (n=43). COVID-19 symptom rebound incidence was higher in the Paxlovid group (18.9%) compared to the control group (7.0%). There were no notable differences in viral rebound by age, gender, pre-existing conditions, or major symptom groups during the acute phase or at the 1-month interval. Conclusion: This preliminary report of our prospective study suggests that rebound after clearance of test positivity or symptom resolution is higher than previously reported. However, we observed a similar rate of rebound in both in the Paxlovid and control groups. Large studies with diverse participants and extended follow-up are needed to better understand the rebound phenomena.
### Competing Interest Statement
MJM is Chief Science Officer of eMed, he is on the board of directors of Quantum-SI, a protein sequencing company, is on the scientific advisory board for ImmuneID, a company that develops immunological tools, and serves on the medical advisory board for 4 Catalyzer. The other authors declare no competing interests.
### Funding Statement
This study was funded by eMed.
### Author Declarations
I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.
Yes
The details of the IRB/oversight body that provided approval or exemption for the research described are given below:
All individuals participating in the study provided informed consent electronically. The protocol for this study was reviewed and approved by the Scripps Office for the Protection of Research Subjects (IRB-22-7978).
I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.
Yes
I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).
Yes
I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.
Yes
This is an ongoing study. We plan to make the de-identified data available after approval of a proposal by a responsible authority at Scripps and with a data access agreement, pledging to not re-identify individuals or share the data with a third party.
Excess Death Rates for Republicans and Democrats During the COVID-19 Pandemic
Founded in 1920, the NBER is a private, non-profit, non-partisan organization dedicated to conducting economic research and to disseminating research findings among academics, public policy makers, and business professionals.
Ein Preprint zu #Paxlovid. Nach eigenem Review halte ich die Daten mit 100tsd Patienten und die Datenquelle für sehr zuverlässig.Das #LongCovid und #PostCovid Risiko sowie Hospitalisieren/Tod NACH durchgemachter Infektion werden reduziert (1/3)https://t.co/tfmQIvcyTr— ECMO_Karagiannidis (@ECMOKaragianni1) November 6, 2022
Ulmer Forscher: Long Covid ist ein massives Problem
Viele Corona-Infizierte leiden monatelang unter Long Covid, also Langzeitfolgen einer Coronainfektion. Das hat eine Studie ergeben, an der die Universität Ulm beteiligt war. Federführend in Ulm ist Jürgen Steinacker.
Dank COVID-19 lernt die Forschung derzeit viel über die Zusammenhänge zwischen Virusinfektionen und Neurodegeneration. Doch ab wann spricht man von Neuro-Covid und was bedeutet das für die Patienten?
Nirmatrelvir and the Risk of Post-Acute Sequelae of COVID-19
Long Covid -- the disease encompassing the post-acute sequelae of SARS-CoV-2 (PASC) -- affects millions of people around the world. Prevention of PASC is an urgent public health priority. In this work, we aimed to examine whether treatment with nirmatrelvir in the acute phase of COVID-19 is associated with reduced risk of post-acute sequelae. We used the healthcare databases of the US Department of Veterans Affairs to identify users of the health system who had a SARS-CoV-2 positive test between March 01, 2022 and June 30, 2022, were not hospitalized on the day of the positive test, had at least 1 risk factor for progression to severe COVID-19 illness and survived the first 30 days after SARS-CoV-2 diagnosis. We identify those who were treated with oral nirmatrelvir within 5 days after the positive test (n=9217) and those who received no COVID-19 antiviral or antibody treatment during the acute phase of SARS-CoV-2 infection (control group, n= 47,123). Inverse probability weighted survival models were used to estimate the effect of nirmatrelvir (versus control) on a prespecified panel of 12 post-acute COVID-19 outcomes and reported as hazard ratio (HR) and absolute risk reduction (ARR) in percentage at 90 days. Compared to the control group, treatment with nirmatrelvir was associated with reduced risk of PASC (HR 0.74 95% CI (0.69, 0.81), ARR 2.32 (1.73, 2.91)) including reduced risk of 10 of 12 post-acute sequelae in the cardiovascular system (dysrhythmia and ischemic heart disease), coagulation and hematologic disorders (deep vein thrombosis, and pulmonary embolism), fatigue, liver disease, acute kidney disease, muscle pain, neurocognitive impairment, and shortness of breath. Nirmatrelvir was also associated with reduced risk of post-acute death (HR 0.52 (0.35, 0.77), ARR 0.28 (0.14, 0.41)), and post-acute hospitalization (HR 0.70 (0.61, 0.80), ARR 1.09 (0.72, 1.46)). Nirmatrelvir was associated with reduced risk of PASC in people who were unvaccinated, vaccinated, and boosted, and in people with primary SARS-CoV-2 infection and reinfection. In sum, our results show that in people with SARS-CoV-2 infection who had at least 1 risk factor for progression to severe COVID-19 illness, treatment with nirmatrelvir within 5 days of a positive SARS-CoV-2 test was associated with reduced risk of PASC regardless of vaccination status and history of prior infection. The totality of findings suggests that treatment with nirmatrelvir during the acute phase of COVID-19 reduces the risk of post-acute adverse health outcomes. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This research was funded by the United States Department of Veterans Affairs. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The Institutional Review Board of the VA Saint Louis Health Care System gave approval of this study. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes Data is available from the US Department of Veterans Affairs
Characterization of autonomic symptom burden in long COVID: A global survey of 2,314 adults - PubMed
Evidence of moderate to severe autonomic dysfunction was seen in 66% of PASC patients in our study, independent of hospitalization status, suggesting that autonomic dysfunction is highly prevalent in the PASC population and independent of the severity of acute COVID-19 illness.
Gut microbiome dysbiosis in antibiotic-treated COVID-19 patients is associated with microbial translocation and bacteremia
Nature Communications - Here, the authors show that SARS-CoV-2 infection causes gut microbiome dysbiosis and gut epithelial cell alterations in a mouse model, and correlate dysbiosis observed in...
AstraZeneca’s covid-19 (mis)adventure and the future of vaccine equity
The pandemic brought vaccine equity to the forefront of public health consciousness like never before—yet the world seems no closer to it. Robert Fortner asks what, if anything, has been learnt The pandemic, for a moment, wobbled the foundations of the drug industry, with calls to elevate lives above profit. “I personally don’t believe that in a time of pandemic there should be exclusive licenses,” the researcher Adrian Hill declared to the New York Times in the spring of 2021. Hill and others at Oxford University, UK, had produced what was then the world’s leading covid-19 vaccine candidate and planned to offer it to manufacturers royalty free. But the insurgency was put down before it ever got off the ground. Oxford swiftly and exclusively licensed its technology to the UK based pharmaceutical giant AstraZeneca. The agreement did include a “non-profit” agreement: initially priced at cost, the vaccine saved more lives from covid-19 than any other in its first year of circulation.1 Yet the no-profit pledge also unleashed a withering crossfire—equity advocates alleging grotesque hypocrisy on one side, market forces on the other. Financial media in the US “clearly didn’t like the idea of a low cost vaccine, undercutting the market,” Hill told the Financial Times .2 AstraZeneca’s vaccine won regulatory approval the world over, but not in the US. Fast forward a year to 2022, and AstraZeneca seems to be exiting the stage before the pandemic ends (box 1), its good deed having earned the company a reputational thrashing.3 Few speak of the AstraZeneca vaccine, while its rivals Moderna and Pfizer-BioNTech look set to profit from ongoing booster shots tailored to new covid-19 variants. These two companies have hauled in billions of dollars during the pandemic and paved the way for a new line of therapeutics based …
Smoking, second-hand smoke exposure and smoking cessation in relation to leukocyte telomere length and mortality - PubMed
Our findings indicated a complex association between smoking, telomere length, and mortality. LTL alterations with SHS and smoking cessation warrant further investigation for translation to public health measures.
Evidence for Biological Age Acceleration and Telomere Shortening in COVID-19 Survivors
The SARS-CoV-2 infection determines the COVID-19 syndrome characterized, in the worst cases, by severe respiratory distress, pulmonary and cardiac fibrosis, inflammatory cytokine release, and immunosuppression. This condition has led to the death of about ...
Three in four (78%) Long COVID sufferers have had to stop, pause, reduce or change their work since experiencing symptoms, according to a new report. With approximately 2.1 million people (3.5% of the population) currently living with Long COVID in the UK and workforce inactivity due to long-term sickness at an all-time high, the study reveals Long COVID’s significant impact on the workforce.
Deaths and hospital admissions are falling, so does this mean that the virus is less severe? The BMJ asks the experts The short answer is no. Covid-19 is still a deadly disease, having killed almost 1.1 million people in 2022 at the time of writing. There remains a high risk of hospital admission and death for anyone without prior immunity. With some populations still largely unexposed to the virus, such as in China, and variation in the types of vaccines used in different places, it would be cavalier to call covid-19 anything but serious. “It’s really hard to compare the severe disease aspects of [variants] because the immunity of our population is so different,” says Steve Griffin, associate professor at the University of Leeds. “When people call omicron mild, yes, there’s probably a lesser tendency for it to go deep in the lungs. But if you think about the clinical impact of it, because of its massive prevalence, even though it’s got a lower chance of causing the sorts of severe disease we’re talking about with acute covid-19, the actual clinical impact is still very, very marked.” David Strain, senior clinical lecturer at the University of Exeter Medical School, points out that covid-19 tends to make other diseases worse. “It doesn’t matter what those other diseases are,” he told The BMJ in August 2022. “Patients who’ve …
“Zudem ist dies die erste Messung 4 Wochen nach Booster. Hier sehen wir zunächst v.a. die "Boosterung" der existierenden AK. Neue Klone (AK), die nach Kontakt mit BA.5 expandieren und affinitätsreifen, werden womöglich erst später wirklich messbar.”
Was genau kann #COVID19 im menschlichen Gehirn anrichten?In einer neuen Studie, die in der Zeitschrift Molecular Psychiatry veröffentlicht wurde, versuchten Forscher aus Schweden und einem Harvard-Krankenhaus in Boston, dies herauszufinden, indem sie…#LongCovid #Corona pic.twitter.com/CIgK3NQbsY— Ralf Wittenbrink (@RWittenbrink) November 7, 2022
Clinical pearls for #LongCovid 1. Find the clots. They are there. If not PE or DVT there are Microclots. 100% of all long Covid patients tested so far have them.— Dr Claire Taylor (@drclairetaylor) November 6, 2022
Ein weiteres Beispiel dafür, dass Viruserkrankungen in der Kindheit das Immunsystem nicht stärken, sondern schwächen können ist das Respiratorische Synzytialvirus (RSV). RSV ist eine häufige Ursache für akute…#COVID19 #ImpfenSchuetzt #LongCovidKids #ProtectTheKids #Corona pic.twitter.com/OQgi9KlbRV— Ralf Wittenbrink (@RWittenbrink) November 5, 2022
‼️Impfung inclu. 2 Booster reduziert das Covid19 Sterbe-Risiko in der Altersgruppe 50+ um 91% zeigen Daten des @CDCgov !Unsere2.- Boosterquote ist Kathastrophal.Aber was können wir noch tun um zu motivieren??#Boostershot #Booster https://t.co/7dudIwWR7y— OrthopaeDenker (@dokhollidays) October 22, 2022
Impact of COVID-19 vaccination on long COVID: a systematic review and meta-analysis
Background The impact of COVID-19 vaccination on preventing or treating long COVID is unclear. We aim to assess the impact of COVID vaccinations administered (i) before and (ii) after acute COVID-19, including vaccination after long COVID diagnosis, on the rates or symptoms of long COVID. Methods We searched PubMed, Embase, Cochrane COVID-19 trials, and Europe PMC for preprints from 1 Jan 2020 to 16 Feb 2022. We included trials, cohort, and case control studies reporting on long COVID cases and symptoms with vaccine administration both before and after COVID-19 diagnosis as well as after long COVID diagnosis. Risk of bias was assessed using ROBINS-I. Results We screened 356 articles and found no trials, but 6 observational studies from 3 countries (USA, UK, France) that reported on 442,601 patients. The most common long COVID symptoms studied include fatigue, cough, loss of smell, shortness of breath, loss of taste, headache, muscle ache, trouble sleeping, difficulty concentrating, worry or anxiety, and memory loss or confusion. Four studies reported data on vaccination before SARS-CoV-2 infection, of which three showed statistically significant reduction in long COVID: the odds ratio of developing long COVID with one dose of vaccine ranged between OR 0.22 to 1.03; with two doses OR 0.51 to 1; and with any dose OR 0.85 to 1.01. Three studies reported on post-infection vaccination with odds ratios between 0.38 to 0.91. The high heterogeneity between studies precluded any meaningful meta-analysis. Studies failed to adjust for potential confounders such as other protective behaviours, and missing data, thus increasing the risk of bias, and decreasing the certainty of evidence to low. Discussion Current studies suggest that COVID-19 vaccinations may have protective and therapeutic effects on long COVID. However, more robust comparative observational studies and trials are urgently needed to clearly determine effectiveness of vaccines in prevention and treatment of long COVID. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement OB is supported by NHMRC Grant APP1106452. PG is supported by NHMRC Australian Fellowship grant 1080042. There was no funding source for this study. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All data produced in the present work are contained in the manuscript
“Since Omicron in late 2021, mRNA booster protection vs infections & transmission declined substantially. But there are still major positive, data-driven (see prior posts for links) attributes for their net benefit for now. I've tried to summarize the + and - in a brief table.”
We advise that patients who have COVID-19, or who are suspected of having COVID-19, should follow careful steps to ensure good mouth care during and after their illness.
This advice is based on: 1) research demonstrating that the mouth is a reservoir of SARS-CoV-2 (the virus that causes COVID-19) and is a site of virus copying; and 2) research which suggests that the virus could pass from saliva into the blood vessels of the mouth and then travel to the lungs via the bloodstream, rather than just by inhalation into the airways of the lungs.
NOT BENIGN—"It's messing with our brains”—#COVID increases ⬆️risk of 44 neurological disorders, including Alzheimer's, 1 year post-infection—says @zalaly, as well as tremors, strokes, encephalitis & more. #LongCovid is real. @hereandnowrobin @hereandnow https://t.co/qFuoxGhZSW pic.twitter.com/Xk9Kx305G0— Eric Feigl-Ding (@DrEricDing) October 10, 2022
Outcomes among confirmed cases and a matched comparison group in the Long-COVID in Scotland study
Nature Communications - In this population-based cohort study from Scotland, the authors investigate the prevalence of symptoms in the post-acute phase of COVID-19 infection compared to matched...