Tag Archives: symptoms

COVID-19 patients still have symptoms 6 months later; interferon may be helpful treatment after all

By Nancy Lapid

(Reuters) – The following is a roundup of some of the latest scientific studies on the novel coronavirus and efforts to find treatments and vaccines for COVID-19, the illness caused by the virus.

Half a year later, COVID-19 patients still have symptoms

Most patients hospitalized with COVID-19 have at least one symptom six months after falling ill, according to findings from a study in Wuhan, China, where the novel coronavirus first emerged in late 2019. Doctors there tracked 1,733 patients who were diagnosed and hospitalized between January, 2020 and May. Six months later, 76% had at least one symptom including fatigue or muscle weakness (seen in 63%), sleep difficulties and anxiety or depression. Most of those who had been severely ill had ongoing lung problems and chest abnormalities that could indicate organ damage, while 13% of patients whose kidneys functioned normally in the hospital went on to develop kidney problems later, researchers reported on Friday in The Lancet. “We are only beginning to understand” some of the long-term effects of COVID-19, study coauthor Bin Cao from the China-Japan Friendship Hospital in Beijing said in a statement. “Our analysis indicates that most patients continue to live with at least some of the effects of the virus after leaving hospital,” highlighting the need for post-discharge care.

Interferon boosts proteins that deny entry to coronavirus

An experimental inhaled form of interferon being tested for treating hospitalized COVID-19 patients may not have a limitation researchers had feared. A potential problem with interferon is that it increases levels of a protein called ACE2, which the new coronavirus uses as a gateway into cells. In test tube experiments, researchers looked at cells that line the path from the nose into the lungs and discovered there are actually two forms of ACE2 – the well known one and a short form that lacks the entryway used by the virus. Interferon increases the short form of ACE2 but not the longer form, they found, which means it does not appear to boost entry points for the virus. “We were excited to discover a new form of ACE2,” Dr. Jane Lucas of the University of Southampton, who co-led the study reported on Monday in Nature Genetics, said in a statement. “We believe this may have important implications for managing COVID-19 infection.” An inhaled interferon from Synairgen Plc is being tested in late-stage trials.

Saliva viral load improves prediction of COVID-19 severity

The amount of the new coronavirus in saliva might help guide doctors’ care of patients because it is a better predictor of disease course than viral load in swab samples obtained from the nose and the back of the throat, researchers said. They studied 26 mildly ill COVID-19 patients, 154 hospitalized patients – including 63 who became critically ill and 23 who eventually died – and 108 uninfected individuals. Saliva viral load, but not nasopharyngeal viral load, was linked with COVID-19 risk factors like age and gender, and with immune system responses. Saliva viral load was also superior to nasopharyngeal viral load at predicting critical illness and death, the researchers reported on Wednesday on medRxiv ahead of peer review. Saliva contains inhaled germs that are cleared from the lungs by the body’s protective mechanisms, coauthor Akiko Iwasaki of Yale University explained in a tweet on Sunday. The saliva viral load therefore reflects how well the virus is making copies of itself all the way through the respiratory tract, from the nose to the lungs, and not just in the nose and back of the throat, Iwasaki said.

(Reporting by Nancy Lapid; Editing by Bill Berkrot)

AstraZeneca vaccine can be up to 90% effective; COVID-19 reinfection unlikely for at least six months

By Nancy Lapid

(Reuters) – The following is a roundup of some of the latest scientific studies on the novel coronavirus and efforts to find treatments and vaccines for COVID-19, the illness caused by the virus.

AstraZeneca COVID-19 vaccine shows up to 90% efficacy

An interim analysis of late-stage trials of AstraZeneca’s COVID-19 vaccine finds it prevented 70% of COVID-19 cases with no confirmed serious adverse effects, the company announced on Monday. In 8,895 participants who got two full doses, the efficacy was 62%. But due to a dosing error that proved to be a happy accident, among 2,741 volunteers who got a half dose followed by a full dose, efficacy rose to 90%. Pfizer and Moderna reported that their vaccines were about 95% effective at preventing illness. But AstraZeneca’s vaccine is cheaper, easier to make, and can be stored at normal refrigerator temperatures. Investment analysts at SVB Leerink said Astra’s vaccine was unlikely to gain U.S. approval because safety data so far are inadequate and the trial design did not meet U.S. requirements for representation of high-risk groups such as the elderly and minorities. AstraZeneca said it plans to seek approval to modify its U.S. study to get more data on the smaller initial dose. Eventually, all three vaccines could prove comparable. “My suspicion is that by the time we are a year down the line, we’ll be using all three vaccines with about 90% protection,” said immunologist Danny Altmann of Imperial College London.

COVID-19 reinfection appears unlikely for at least 6 months

People who have had COVID-19 are unlikely to contract it again for at least six months, British researchers said on Thursday in a report posted on medRxiv ahead of peer review. Between April and November, they tracked more than 12,000 frontline healthcare workers at high risk for infection with the new coronavirus. COVID-19 with symptoms occurred in 89 of 11,052 workers who did not already have antibodies showing exposure to the virus, whereas none of the 1,246 staff with antibodies developed a recurrent infection. Staff with antibodies were also less likely to test positive for COVID-19 without symptoms, the researchers said. “This is really good news because we can be confident that, at least in the short term, most people who get COVID-19 won’t get it again,” said coauthor David Eyre of Oxford’s Nuffield Department of Population Health. Maria van Kerkhove of the World Health Organization added, “We still need to follow these individuals for a longer period of time to see how long immunity lasts.”

Delirium may signal COVID-19 in elderly

Delirium is common among older patients with COVID-19 and may be their only symptom, U.S. researchers warned on Thursday in JAMA Network Open. Among more than 800 COVID-19 patients over age 65 who showed up at emergency departments around the country, nearly 30% had delirium, they found. Overall, delirium was the sixth most common of all the symptoms and signs in these older patients. Those most at risk for delirium included elders with vision or hearing impairment, stroke, Parkinson’s disease and residents of assisted living or skilled nursing facilities. Delirium is not on any official list of COVID-19 signs and symptoms, but the U.S. Centers for Disease Control and Prevention (CDC) should add it, said coauthor Dr. Maura Kennedy of Massachusetts General Hospital in Boston. “Sometimes delirium is the chief complaint when these patients arrive at the emergency department,” Kennedy said. “But there can be a number of reasons they come, including falls that occurred because of the delirium. They may present without what we consider typical COVID-19 symptoms, such as fever, shortness of breath and cough.”

New data help distinguish COVID-19 from flu

Certain findings can help distinguish COVID-19 from influenza or other respiratory illnesses, a new study suggests. Israeli doctors studied 693 hospitalized patients with COVID-19, plus more than 8,000 adults who had been hospitalized in previous years for the flu or severe respiratory infections. Compared to the other patients, those with COVID-19 were on average younger, more overweight, and had fewer preexisting conditions other than dementia, which was more prevalent in COVID-19 patients. Upon hospital admission, COVID-19 patients had overall lower levels of infection-fighting white blood cells and neutrophils, but their hearts were beating faster, they had less oxygen in their blood, and they had higher percentages of immune-system B cells, which produce antibodies to attack invading germs, and T cells, which destroy cells that have become infected. During the first two days of hospitalization, white blood cell and neutrophil levels rose in COVID-19 patients but fell in the other groups, the researchers said in a paper posted on Sunday on medRxiv ahead of peer review. “At the dawn of winter, recognizing the characteristics discriminating COVID-19 from influenza, will be critical to support the management of the current pandemic,” they conclude.

(Reporting by Nancy Lapid, Linda Carroll, Kate Holton, Josephine Mason and Kate Kelland; Editing by Bill Berkrot)

Highly effective vaccine, new warning signs, disrupted heart rhythm

By Nancy Lapid

(Reuters) – The following is a roundup of some of the latest scientific studies on the novel coronavirus and efforts to find treatments and vaccines for COVID-19, the illness caused by the virus.

Pfizer vaccine appears highly effective

An experimental COVID-19 vaccine from Pfizer Inc and BioNTech SA appears to be more than 90% effective, based on data analyzed midway through a gold-standard clinical trial, the companies announced on Monday. The trial has enrolled 43,538 participants so far, including many from racially and ethnically diverse backgrounds. Pfizer said researchers had analyzed 94 confirmed cases of COVID-19 in trial participants and found the vast majority of the infections were in volunteers in the placebo group. The trial is expected to continue until 164 confirmed cases of COVID-19 are available for analysis. BioNTech’s co-founder and chief executive said he was optimistic that the protective effect of the experimental COVID-19 vaccine would last for at least a year.

New study adds to COVID-19 symptom list

Fever, coughing, and shortness of breath are known symptoms of COVID-19, but other warning signs can include weakness, poor blood sugar control and gastrointestinal complaints, according to a new study published on Saturday in the American Journal of Emergency Medicine. Researchers analyzed nearly 12,000 visits by adult patients to emergency departments at five New York City hospitals. They found COVID-19 in 57.5% of patients who went to the hospital because of weakness, falls, or altered mental status, in 55.5% of those who came in because their blood sugar was out of control, and in 51.4% of patients whose chief complaint was a gastrointestinal problem. Patients over the age of 65 tended to have more atypical complaints such as diarrhea, fatigue and weakness. Patients with dehydration, altered mental status, falls and high blood sugar were at higher risk for death in the study. The new findings can help hospitals provide better care and are “also important for family members and people that work with the elderly to better identify possible warning signs of COVID-19 infection,” coauthor Dr. Christopher Clifford of the Icahn School of Medicine at Mount Sinai told Reuters.

COVID-19 can fuse heart cells, disrupt rhythm

COVID-19 can disrupt the heart’s electric system, according to a report undergoing peer review at a Nature Research journal. The heart pumps blood by sending electrical signals through its “conducting cells” to tell “muscle cells” to contract. Normally, each conducting cell activates the one next to it in a domino effect to ensure smooth contractions. An autopsy of a COVID-19 patient found the virus had infected her heart in an unusual patchy pattern, “with small islands of infected cells here and there,” Dr. Jay Schneider of the Mayo Clinic in Rochester, Minnesota told Reuters. Upon further study in the laboratory, his team realized the spike protein on the surface of the new coronavirus can create holes between neighboring cells, causing them to fuse together. So instead of orderly electrical signal transmission and a steady heart rhythm, the signals flow like “a tsunami tidal wave” through the fused cells.

(Reporting by Nancy Lapid; Editing by Tiffany Wu)

COVID-19 antibodies last at least three months; so do symptoms for many

By Nancy Lapid

(Reuters) – The following is a roundup of some of the latest scientific studies on the novel coronavirus and efforts to find treatments and vaccines for COVID-19, the illness caused by the virus.

COVID-19 antibodies last at least three months

People infected with COVID-19 develop antibodies targeting the new coronavirus that last for at least three months, according to two reports published on Thursday in Science Immunology. The two studies, together involving nearly 750 patients, both point to immunoglobulin G (IgG) antibodies, which start showing up well after an infection begins, as the longest-lasting. Researchers found IgG antibodies with two targets – a spike protein on the virus that helps it infect cells, and a part of the spike called the receptor binding domain (RBD) – lasted more than 100 days. While the protective effect of COVID-19 antibodies is not completely clear, Jen Gommerman of the University of Toronto, coauthor of the study, said her team also found levels of so-called neutralizing antibodies, which inactivate the virus, “appeared to be very stable.” The other study, from Harvard Medical School, reported similar findings. This means that a properly designed vaccine “should elicit a durable antibody response that has the potential to neutralize the virus,” Gommerman said. Her group also found that antibodies in saliva correlated with antibodies in blood, but at this point the saliva tests are not sensitive enough to replace blood tests.

COVID-19 symptoms linger for months for many

Three months after becoming ill, many COVID-19 patients still have symptoms, two studies confirm, and the more severe the initial infections, the higher the odds of persistent problems. In Spain, doctors checked back with 108 patients, including 44 who had been severely ill. At 12 weeks after diagnosis, 76% still reported after-effects, with 40% reporting three or more coronavirus-related health issues, doctors said in a paper posted on Thursday on medRxiv ahead of peer review. The most common complaints were shortness of breath, physical weakness, cough, chest pain, palpitations, and psychological and cognitive disorders. In a similar study of 233 U.S. COVID-19 patients – eight of whom had been severely ill – one in four still had symptoms 90 days after first feeling ill. Rates were higher for patients who had been sicker: 59.4% at 30 days and 40.6% at 90 days. “But even for very mild and initially asymptomatic cases, 14.3% have complications persist for 30 days or longer,” the authors reported on Sunday on medRxiv. In the U.S. study, the most common persistent symptoms were impaired smell and taste, difficulty concentrating, shortness of breath, memory loss, confusion, headache, heart palpitations, chest pain, pain with deep breaths, dizziness, and rapid heartbeat.

Remdesivir cut COVID-19 recovery time by 5 days

Final data from a large study of Gilead Sciences Inc’s antiviral drug remdesivir showed the treatment cut COVID-19 recovery time by five days among hospitalized patients, one day faster than preliminary data had indicated, researchers reported on Thursday in The New England Journal of Medicine. The 1,062-patient study compared up to up to 10 days of therapy with remdesivir – now sold in some markets as Veklury – to a placebo. The average recovery time was 10 days among those who got the Gilead drug versus 15 days in the placebo group. Among patients requiring oxygen at the start, those taking remdesivir continued to need oxygen for an average of 13 days, compared to 21 days for patients who got a placebo. In a separate analysis looking just at patients who received oxygen, the drug appeared to reduce the risk of death over the next month by 70%. “We now have data suggesting that giving remdesivir to patients on oxygen may significantly reduce their chances of death compared to other subgroups,” Dr. Andre Kalil, an infectious disease expert at the University of Nebraska Medical Center and the study’s lead investigator, said in a news release.

Coronavirus rarely travels from mother to newborn

Transmission of the new coronavirus from mothers to newborns is rare, doctors from New York-Presbyterian/Columbia University Irving Medical Center reported on Monday in JAMA Pediatrics. They studied 101 babies born to 100 mothers with COVID-19, including 10 whose mothers had been severely ill. Almost all of the babies tested negative for the virus, while tests in two newborns had indeterminate results. If these two indeterminate results are considered positive, the overall incidence of transmission was 2.0%. Even with a 2% transmission rate, “none of our babies exhibited clinical symptoms of COVID-19, either during their newborn nursery stay or during … the first few weeks of life,” coauthor Dr. Dani Dumitriu told Reuters Health by email. Roughly 90% of the newborns were breastfed at least partially. “As the country heads into what looks like a second wave of the COVID-19 pandemic, it is important to know that separation of affected mothers from their newborns may not be warranted, and direct breastfeeding appears to be safe,” study coauthor Dr. Melissa Stockwell said.

(Reporting by Nancy Lapid, Julie Steenhuysen and Will Boggs; Editing by Bill Berkrot)

Coronavirus patients most infectious when they first feel unwell: WHO

By Stephanie Nebehay

GENEVA (Reuters) – Studies show people with the coronavirus are most infectious just at the point when they first begin to feel unwell, World Health Organization (WHO) experts said on Tuesday.

This feature has made it so hard to control the spread of the virus that causes COVID-19 disease, but it can be done through rigorous testing and social distancing, they said.

“It appears from very limited information we have right now that people have more virus in their body at or around the time that they develop symptoms, so very early on,” Maria van Kerkhove, a WHO epidemiologist and technical lead on the pandemic, told a live session on social media.

Preliminary studies from Germany and the United States suggest that people with mild symptoms can be infectious for up to 8-9 days, and “it can be a lot longer for people who are more severely ill”, she said.

Earlier, some disease experts questioned her statement on Monday that transmission of COVID-19 by people with no symptoms is “very rare”, saying this guidance could pose problems for governments as they seek to lift lockdowns.

Van Kerkhove, citing disease-modeling studies, clarified on Tuesday that some people do not develop symptoms, but can still infect others.

“Some estimates of around 40 percent of transmission may be due to asymptomatic (cases), but those are from models. So I didn’t include that in my answer yesterday but wanted to make sure that I made that clear,” she said.

Dr. Mike Ryan, WHO’s top emergency expert, said that the novel coronavirus lodges in the upper respiratory tract, making it easier to transmit by droplets than related viruses such as SARS or MERS, which are in the lower tract.

“Now as we look at COVID-19, we have an infectious pathogen that is present in the upper airway for which the viral loads are peaking at the time you are just beginning to get sick,” he said.

“That means you could be in the restaurant feeling perfectly well and start to get a fever, you are feeling ok, you didn’t think to stay home, but that’s the moment at which your viral load could be actually quite high,” he said.

Ryan added: “And it’s because the disease can spread at that moment that the disease is so contagious, that’s why it spread around the world in such an uncontained way, is because it’s hard to stop this virus.”

But some countries have shown that transmission can be brought down to “an acceptable level or even to no level”, as New Zealand had recently demonstrated, he said.

(Additional reporting by Josephine Mason; Writing by Nick Macfie and Stephanie Nebehay; Editing by Kevin Liffey and Giles Elgood)

Loss of taste and smell key COVID-19 symptoms, app study finds

By Kate Kelland

LONDON (Reuters) – Losing your sense of smell and taste may be the best way to tell if you have COVID-19, according to a study of data collected via a symptom tracker app developed by scientists in Britain and the United States to help monitor the coronavirus pandemic.

Almost 60% of patients who were subsequently confirmed as positive for COVID-19 had reported losing their sense of smell and taste, data analysed by the researchers showed.

That compared with 18% of those who tested negative.

These results, which were posted online but not peer-reviewed, were much stronger in predicting a positive COVID-19 diagnosis than self-reported fever, researchers at King’s College London said.

The app, which the researchers say could help slow the outbreak and identify more swiftly those at risk of contracting COVID-19, can be downloaded via the URL covid.joinzoe.com.

If enough people participate in sharing their symptoms, the scientists said, the app could also provide healthcare systems with critically valuable information.

“This app-based study is a way to find out where the COVID-19 hot spots are, new symptoms to look out for, and might be used as a planning tool to target quarantines, send ventilators and provide real-time data to plan for future outbreaks,” said Andrew Chan, a professor of medicine at Harvard Medical School in the United States who is co-leading the study.

Of 1.5 million app users between March 24 and March 29, 26% reported one or more symptoms through the app. Of these, 1,702 also reported having been tested for COVID-19, with 579 positive results and 1,123 negative results.

MATHEMATICAL MODEL

Using all the data collected, the research team developed a mathematical model to identify which combination of symptoms – ranging from loss of smell and taste, to fever, persistent cough, fatigue, diarrhoea, abdominal pain and loss of appetite -was most accurate in predicting COVID-19 infection.

“When combined with other symptoms, people with loss of smell and taste appear to be three times more likely to have contracted COVID-19 according to our data, and should therefore self-isolate for seven days to reduce the spread of the disease,” said Tim Spector, a King’s professor who led the study.

Trish Greenhalgh, a professor of primary care health sciences at Britain’s Oxford University and who is not involved in the study, said it was the first to demonstrate scientifically and in a large population sample that loss of smell is a characteristic feature of COVID-19.

Spector’s team applied their findings to the more than 400,000 people reporting symptoms via the app who had not yet had a COVID-19 test, and found that almost 13% of them are likely to be infected.

This would suggest that some 50,000 people in Britain may have as yet unconfirmed COVID-19 infections, Spector said.

(Reporting by Kate Kelland, editing by Grant McCool and Gareth Jones)

Flu Spreading Rapidly across the Country, CDC reports increase since Christmas

Weekly report of widespread flu cases throughout the US from the CDC

By Kami Klein

Flu season is upon us and this year according to the CDC, reports do not look good. In states like California, pharmacies are running out of flu medicine, emergency rooms are packed with patients, and the death toll is three times higher now than this time last year.  So far, in that state alone 27 people under the age of 65 have died since October.  And the cases have now spread across the country.   

The flu outbreak covers the entire United States with many hospitals filling to capacity.  Although it has not been called an epidemic yet, this year’s flu season has already spread faster and further than it did last year at this time. The CDC has also reported that during the week of Christmas the flu virus has increased sharply across the nation.  

The Los Angeles Times reported that UCLA Medical Center in Santa Monica are seeing over 200 patients a day in emergency rooms.  Dr. Wally Ghurabi, the ER medical director remarked on what they are seeing daily, “The Northridge earthquake was the last time we saw over 200 patients.”  

Methodist Dallas Medical Center’s emergency room is so overrun with flu cases that it is asking people with non-emergency symptoms to go to urgent care centers or see a primary care physician. And many hospitals have gone into diversion mode having to send ambulances to other hospitals and not accepting flu patients.  

The most prevalent strain of flu that is being reported by public health laboratories is influenza A(H3).  Symptoms come on suddenly and can begin with any of these symptoms; Body Aches, Fever, Headache, Sore Throat, Cough, Exhaustion, Cold like symptoms of Congestion and more frequently in children can include Vomiting and Diarrhea.

According to the CDC, most healthy adults may be able to infect other people beginning 1 day before symptoms develop and up to 5 to 7 days after becoming sick. Symptoms start 1 to 4 days after the virus enters the body. That means that you may be able to pass on the flu to someone else before you know you are sick, as well as while you are sick. Some people can be infected with the flu virus but have no symptoms. During this time, those persons may still spread the virus.

It is vital to note that people with the flu can spread it to others from up to about 6 feet away when those infected cough, sneeze or talk and the droplets land in the mouths or noses of people nearby or are inhaled into the lungs. A person might also get flu by touching a surface or object that has flu virus on it and then touching their own mouth or nose.

If you have been exposed to the flu, being aware of the risk of spreading is vital to slowing down this virus. Encourage family, friends and co-workers to frequent hand washing for at least 20 seconds with soap and water or use an alcohol based hand rub. Frequently touched surfaces such as telephones, computer keyboards, desks, doorknobs, light switches, should be cleaned and disinfected especially if someone ill has been around them.  

Anyone who is sick should stay home! By going to work or school you are only putting others who come into contact with you and their families at risk. Those who are the most vulnerable for this virus to become fatal are the very young, the elderly, and those that have other medical conditions. But there have been reports of healthy adults who are succumbing to this virus.  

Nobody is immune to the flu virus.  Health officials say that it is not too late for a flu shot even though at this time the current vaccine is only 10% effective in avoiding this strain of flu, but are also stating that while the flu shot may not protect you from the getting the flu it can absolutely help in your recovery if you are exposed to it.  

 

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