The burden and dynamics of hospital-acquired SARS-CoV-2 in England
Nature - Data from acute hospitals in England are used to quantify hospital-acquired SARS-CoV-2 infections, evaluate likely pathways of spread and factors associated with heightened transmission...
Assessing and improving the validity of COVID-19 autopsy studies - A multicentre approach to establish essential standards for immunohistochemical and ultrastructural analyses
Since detection of SARS-CoV-2 in human autopsy tissues by IHC and EM is difficult and frequently incorrect, we propose criteria for a re-evaluation of available data and guidance for further investigations of direct organ effects by SARS-CoV-2.
Endothelial cell infection and endotheliitis in COVID-19
Cardiovascular complications are rapidly emerging as a key threat in coronavirus disease 2019 (COVID-19) in addition to respiratory disease. The mechanisms underlying the disproportionate effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on patients with cardiovascular comorbidities, however, remain incompletely understood.1,2
Immer mehr Studien belegen, dass COVID-19-Patienten ein deutlich erhöhtes Risiko für Gefäßerkrankungen haben. Blutverdünnern könnten die Sterblichkeit möglicherweise verringern.
An atlas of continuous adaptive evolution in endemic human viruses
Kistler and Bedford examine the genomes of 28 human endemic viruses and estimate that 10 of these viruses are undergoing antigenic evolution. This demonstrates that evasion of antibody detection is not an uncommon evolutionary strategy among the viruses that commonly infect humans.
🇩🇪2023-PROTOKOLLEMIT ANTIMIKROBIELLEN/ANTIVIRALENFÜRLONG-COVID, POST-COVID-SYNDROMPOST-V-SYNDROMME/CFSFIBROMYALGIEPOTS, TACHYKARDIEDYSAUTONOMIEKOGNITIVE BEEINTRÄCHTIGUNG,DEMENZAUTOIMMUNERKRANKUNGUND ANDERE MIT CHRONISCHER MÜDIGKEIT UND SCHMERZENhttps://t.co/N46RJlcztR pic.twitter.com/JQuy18NwlN— Dr. Gustavo Aguirre-Chang (@Aguirre1Gustavo) September 11, 2023
Could SARS-CoV-2 Have Bacteriophage Behavior or Induce the Activity of Other Bacteriophages?
SARS-CoV-2 has become one of the most studied viruses of the last century. It was assumed that the only possible host for these types of viruses was mammalian eukaryotic cells. Our recent studies show that microorganisms in the human gastrointestinal tract affect the severity of COVID-19 and for the first time provide indications that the virus might replicate in gut bacteria. In order to further support these findings, in the present work, cultures of bacteria from the human microbiome and SARS-CoV-2 were analyzed by electron and fluorescence microscopy. The images presented in this article, in association with the nitrogen (15N) isotope-labeled culture medium experiment, suggest that SARS-CoV-2 could also infect bacteria in the gut microbiota, indicating that SARS-CoV-2 could act as a bacteriophage. Our results add new knowledge to the understanding of the mechanisms of SARS-CoV-2 infection and fill gaps in the study of the interactions between SARS-CoV-2 and non-mammalian cells. These findings could be useful in suggesting specific new pharmacological solutions to support the vaccination campaign.
Viral kinetics of sequential SARS-CoV-2 infections
Nature Communications - In this study, the authors compare the viral kinetics of first and second SARS-CoV-2 infections using data from an occupational surveillance scheme in the National...
In individuals with multiple infections, second infections were cleared more quickly than first infections. Furthermore, one’s relative speed of clearing infection roughly persisted across infections. Those with a relatively fast clearance speed in their first infection tended to have a relatively fast clearance speed in their second infection, and vice versa. Thus, while prior infection and vaccination can modulate a person’s viral kinetics in absolute terms, there may also exist some further immunological mechanism, conserved across sequential infections, that determines one’s strength of immune response against SARS-CoV-2 relative to others in the population.
A consistent finding between this and other studies on SARS-CoV-2 viral kinetics is that prior antigenic exposure, through infection or vaccination, tends to speed up viral clearance, and thus to reduce the duration of test positivity5,11,15. The duration of viral positivity has various consequences both for clinical management and for public health surveillance. For clinical management, test results should be interpreted in the context of a patient’s immune history, which can modulate both the extent and expected duration of viral shedding5,16. It may also be possible to adjust the recommended duration of post-infection isolation based on infection history.
COVID-19 vaccine-associated mortality in the Southern Hemisphere
CORRELATION has published a new report entitled “COVID-19 vaccine-associated mortality in the Southern Hemisphere” authored by Denis G. Rancourt, Marine Baudin, Joseph Hickey, and Jérém…
SARS-CoV-2 infection induces DNA damage, through CHK1 degradation and impaired 53BP1 recruitment, and cellular senescence
Nature Cell Biology - Gioia, Tavella et al. show that severe acute respiratory syndrome coronavirus 2 causes DNA damage through CHK1 degradation and impairs 53BP1 recruitment to DNA lesions. The...
COVID’s – and other viruses’ – Achilles' heel identified!Researchers have identified how the SARS-CoV-2 virus that causes COVID-19 takes advantage of our cellular machinery to replicate and spread in the body, and, importantly, a way to stop it. 1/— Vipin M. Vashishtha (@vipintukur) September 15, 2023
Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study
After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities
in the medium term. Our findings emphasise the need for proactive multidisciplinary
care pathways, with the potential for imaging to guide surveillance frequency and
therapeutic stratification.
Langzeitorganschäden bei einigen posthospitalisierten COVID-Patienten bestätigt
DMZ – WISSENSCHAFT ¦ Lena Wallner ¦ Eine aktuelle Studie, die sich mit den langfristigen Folgen von COVID-19 beschäftigt hat, hat alarmierende Ergebnisse erbracht. Fast ein Drittel der Patienten, die fünf Monate nach ihrer Infektion untersucht wurden, wies Abweichungen in mehreren Organen auf. Einige dieser Abweichungen wurden bereits in vorherigen Untersuchungen als Anzeichen für Gewebeschäden identifiziert. Die Studie nutzte Magnetresonanztomographie (MRT)-Scans, um die Organzustände der Patienten zu analysieren. Dabei zeigte sich, dass diejenigen, die an der Studie teilnahmen, im Vergleich zur Kontrollgruppe eine erheblich höhere Anzahl an auffälligen Befunden in den Organen aufwiesen. Insbesondere fielen die Lungenveränderungen bei den Patienten auf, die nach ihrer COVID-19-Behandlung aus dem Krankenhaus entlassen wurden. Hier lag die Rate fast 14-mal höher als in der Kontrollgruppe. Auch die auffälligen Befunde im Gehirn und an den Nieren waren bei den untersuchten Patienten dreimal beziehungsweise doppelt so häufig wie bei den Mitgliedern der Kontrollgruppe. Der Grad der Abnormalitäten in den MRT-Scans wurde oft durch die Schwere der COVID-19-Infektion beeinflusst, die die Patienten erlebt hatten, sowie durch ihr Alter und vorhandene Begleiterkrankungen. Die Ergebnisse, die in "The Lancet Respiratory Medicine" veröffentlicht wurden, sind Teil der C-MORE (Capturing the MultiORgan Effects of COVID-19)-Studie. C-MORE ist eine multizentrische MRT-Follow-up-Studie mit 500 posthospitalisierten COVID-19-Patienten und ein wichtiger Bestandteil der nationalen PHOSP-COVID-Plattform, die von der University of Leicester geleitet wird und die langfristigen Auswirkungen von COVID-19 auf hospitalisierte Patienten untersucht. Dieser Artikel präsentiert die Ergebnisse einer Zwischenanalyse von 259 posthospitalisierten COVID-19-Patienten und 52 Kontrollpersonen. Die C-MORE-Studie wird von Forschern des Radcliffe Department of Medicine der University of Oxford geleitet und von den National Institute for Health Research (NIHR) Oxford Biomedical Research Centre (BRC) und NIHR Oxford Health BRC sowie dem BHF Oxford Centre for Research Excellence und dem Wellcome Trust unterstützt. Die Teilnehmer, die an 13 Standorten im Vereinigten Königreich rekrutiert wurden, unterzogen sich im Durchschnitt fünf Monate nach ihrer Entlassung aus dem Krankenhaus MRT-Scans des Herzens, des Gehirns, der Lungen, der Leber und der Nieren. Darüber hinaus wurden Bluttests durchgeführt und Fragebögen ausgefüllt. Dr. Betty Raman, die die C-MORE-Studie leitet, erklärte: "Wir haben festgestellt, dass fast jeder dritte Patient im Vergleich zu den Kontrollen einen erhöhten Anteil an Multiorgan-Anomalien aufwies. Fünf Monate nach der Entlassung aus dem Krankenhaus nach einer COVID-19-Behandlung zeigten die Patienten eine hohe Anzahl von Anomalien in den Lungen, dem Gehirn und den Nieren im Vergleich zu unseren nicht-COVID-19-Kontrollen. Das Alter des Einzelnen, die Schwere der akuten COVID-19-Infektion sowie Begleiterkrankungen waren signifikante Faktoren bei der Feststellung von Organverletzungen im Verlauf." Die Studie ergab, dass einige organspezifische Symptome mit den bildgebenden Hinweisen auf Organverletzungen korrelierten - zum Beispiel Brustenge und Husten bei auffälligen Lungenscans -, aber nicht alle Symptome konnten direkt mit den in den MRT-Scans festgestellten Anomalien in Verbindung gebracht werden. Die Schäden am Herzen und der Leber bei den ehemaligen hospitalisierten COVID-19-Patienten waren ähnlich wie in der Kontrollgruppe. Der Artikel bestätigte auch, dass Multiorgan-MRT-Anomalien häufiger bei posthospitalisierten Patienten auftraten, die nach COVID-19 über schwerwiegend beeinträchtigte körperliche und geistige Gesundheit berichteten, wie es zuvor von den Untersuchern der PHOSP-COVID-Studie beschrieben wurde. "Was wir sehen, ist, dass Menschen mit Multiorganpathologie in der MRT - das heißt, sie hatten mehr als zwei betroffene Organe - viermal häufiger von schweren geistigen und körperlichen Beeinträchtigungen berichteten. Unsere Ergebnisse unterstreichen auch die Notwendigkeit von langfristigen multidisziplinären Nachsorgediensten, die sich auf die pulmonale und extrapulmonale Gesundheit (Nieren, Gehirn und psychische Gesundheit) konzentrieren, insbesondere für diejenigen, die wegen COVID-19 im Krankenhaus behandelt wurden," sagte Dr. Raman. Sie fügte hinzu: "Diese Ergebnisse sind das Ergebnis umfangreicher gemeinsamer Anstrengungen von Forschern im gesamten Vereinigten Königreich. Wir sind unglaublich dankbar für die Patienten und die Öffentlichkeit, die an dieser Studie teilgenommen haben." Professor Chris Brightling vom NIHR Leicester BRC, der die PHOSP-COVID-Studie leitet, erklärte: "Diese detaillierte Studie zur Ganzkörperbildgebung bestätigt, dass Veränderungen in mehreren Organen Monate nach der Hospitalisierung aufgrund von COVID-19 beobachtet werden. Die PHOSP-COVID-Studie arbeitet daran, zu verstehen, warum dies geschieht und wie wir Tests und neue Behandlungen für Long COVID entwickeln können."
‼️Neue Variante BA.86.2 „Pirola“Es gibt ein paar Symptome die sich von bisherigen Varianten unterscheiden:‼️Eins der wohl Auffälligsten sind Hautausschläge (Siehe Foto aus UK)Laut Datenbanken aus UK (ZOE Health Studie) sind sonst noch folgende weniger häufige besondere… pic.twitter.com/06W62vOHyo— OrthopaeDenker (@dokhollidays) October 7, 2023
Helferzellen gegen Sars-CoV-2: Corona-Impfung: Körper baut Immungedächtnis in Organen auf
Forscher der renommierten Berliner Charité können wohl einen weiteren Beleg für die Wirksamkeit von Impfungen liefern. Sie finden sogenannte Immungedächtniszellen unter anderem in Leber, Nieren und Lunge. Vermutlich helfen sie, das Virus direkt zu bekämpfen.
Klinische Daten: Immunreaktionen nach Booster mit Comirnaty XBB.1.5
Biontech und Pfizer haben den Covid-19-Impfstoff Comirnaty® an die Omikron-Subvariante XBB.1.5 angepasst. Jetzt wurden erste klinische Daten zu den Imm...
Covid-19: Infections climb globally as EG.5 variant gains ground
Recent testing has left little doubt that a new variant of the pandemic coronavirus is gaining ground across the world. The spike mutations of the EG.5 variant—dubbed “eris”—improve its immune escape abilities, experts have said, and probably account for recent modest increases in hospital admissions in Japan, New Zealand, South Korea, the UK, and the US. The omicron EG.5 variant “has shown increased prevalence, growth advantage, and immune escape properties,” according to the most recent risk analysis by the World Health Organization, but “there have been no reported changes in disease severity to date.”1 In the week to 23 July, the EG.5 lineage accounted for 17.4% of test samples sequenced around the world, up from 7.6% four weeks earlier, said WHO. Of these samples, 88% were a subvariant called EG.5.1, which carries an extra spike mutation. The EG.5 lineage has been reported in 51 countries and EG.5.1 is on course to supplant XBB.1.5 (sometimes called “kraken”)2 which first appeared in late 2022, and XBB.1.16 (“Arcturus”),3 which appeared early this year, as the world’s most common subvariant. In China, EG.5 and its subvariants accounted for 24.7% of covid infections …
Alteration of the blood-brain barrier by COVID-19 and its implication in the permeation of drugs into the brain
Diverse neurological symptoms have been reported in patients with SARS-CoV-2 disease (COVID-19), including stroke, ataxia, meningitis, encephalitis, and cognitive impairment. These alterations can cause serious sequelae or death and are associated with the entry of SARS-CoV-2 into the Central Nervous System (CNS). This mini-review discusses the main proposed mechanisms by which SARS-CoV-2 interacts with the blood-brain barrier (BBB) and its involvement in the passage of drugs into the CNS. We performed a search in PubMed with the terms “COVID-19” or “SARS-CoV-2” and “blood-brain barrier injury” or “brain injury” from the year 2019 to 2022. We found proposed evidence that SARS-CoV-2 infects neurovascular cells and increases BBB permeability by increasing the expression of matrix metalloproteinase-9 that degrades type IV collagen in the basement membrane and through activating RhoA, which induces restructuring of the cytoskeleton and alters the integrity of the barrier. The breakdown of the BBB triggers a severe inflammatory response, causing the cytokine storm (release of IL-1β, IL-6, TNF-α, etc.) characteristic of the severe phase of COVID-19, which includes the recruitment of macrophages and lymphocytes and the activation of astrocytes and microglia. We conclude that the increased permeability of the BBB would allow the passage of drugs that would not reach the brain in a normal physiological state, thus enhancing certain drugs’ beneficial or adverse effects. We hope this...
First on CNN: HHS awards more than $500 million to study Covid-19 vaccine nasal sprays and more | CNN
In the future, some Covid-19 vaccines may not be jabs in the arm. They could be a nasal spray or even a patch on the skin. Those are just two examples of the kind of next-generation vaccine technology that federal health officials are hoping to help advance.
Effective contact tracing can halve mass testing frequency needed to control respiratory virus pandemics
Mass testing is a promising strategy to control future respiratory virus pandemics, however, it is limited by the availability of testing capacity. The aim of this work is to predict the effectiveness of contact tracing when used with mass testing, and to what extent contact tracing can reduce the required number of tests. We estimate the effect of contact tracing and mass testing for controlling a variety of respiratory virus pandemics. To do this, we use a branching model with individuals whose infectiousness and probability of testing positive depend on simulated viral load trajectories. We find that the addition of contact tracing is most useful when mass testing is done frequently enough to detect most infections, but cannot be done frequently enough to reliably isolate cases before they infect others. Our results show that the addition of effective contact tracing can prevent the same number of transmissions as doubling the mass testing frequency. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study did not receive any funding ### 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, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All code and data for the present study are available upon reasonable request to the authors
Influence of Prior SARS-CoV-2 Infection on COVID-19 Severity: Evidence from the National COVID Cohort Collaborative
Background As SARS-CoV-2 has transitioned from a pandemic to endemic disease, the majority of new infections have been among previously infected individuals. To manage the risks and benefits of ongoing COVID-19 policies, it is important to understand whether prior infection modifies the severity of subsequent infections. Methods We used data from first and second COVID-19 episodes in the National COVID Cohort Collaborative (N3C), a collection of health systems who provide de-identified electronic health records for research purposes. Our analysis was a sequential series of nested trial emulations. In the first of two analytic stages, we created a month-specific model of the probability of prior infection for each individual. In the second stage, we used an ordinal logistic regression with inverse probability weights calculated in the first stage to simulate a series of monthly trials comparing severity between the cohorts of first and second infections. In addition to cohort-wide effect estimates, we also conducted analyses among race/ethnicity, sex, and age subgroups. Results From an initial cohort of 7,446,481 combined first and second infections, we identified a cohort of 2,227,484 infections, among which 7.6% were second infections. Ninety-four percent of patients with two recorded infections experienced mild disease for both. The overall odds ratio (OR) for more severe disease with prior infection was 1.06 (95% confidence interval [CI]: 1.03 – 1.10). Monthly point estimates of the OR ranged from 0.56 (95% CI: 0.37 – 0.84) in October 2020 to 1.64 (95% CI: 1.33 – 2.00) in February 2023. In most subgroups, the effect of prior infection was significant. In 8 out of 10 subgroups, the maximum monthly OR occurred after the minimum monthly OR, suggesting that protection has waned throughout the pandemic. Conclusion Overall, prior infection was associated with a significant slightly elevated risk of severe disease. This effect varied month to month. As the pandemic proceeded, the effect of prior infection tended to evolve from generally protective during the pre-Omicron era to unprotective during the Omicron era. This points to the need for continued strategies to avert and minimize the harms of COVID-19, rather than relying upon immunity acquired through previous infection. Question Does prior infection with SARS-CoV-2 affect the severity of subsequent COVID-19 episodes? Findings We observed a mild protective effect of prior infection during the early and mid-stages of the pandemic that waned after the rise of the Omicron variants, ultimately resulting in loss of protection or a tendency toward more severe second infections. Meaning Prior infection alone is likely not enough to avert the worst public health harms of endemic SARS-CoV-2. Interventions to avoid infection and reduce the severity of COVID-19 will still be important in the post-pandemic era. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This project was sponsored by an award from the National COVID Cohort Collaborative's Public Health Answers to Speed Tractable Results (PHASTR) program and the National Center for Advancing Translational Sciences (Award #NCATS-P00438-E-2). ### 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 study design was exempted from human subjects research review by the American Academy of Family Medicine institutional review board. 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, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data are available online through the National COVID Cohort Collaborative () with signed data use agreement and project approval.
Overall, prior infection was associated with a significant slightly elevated risk of severe disease.
