Category: COVID

Categories : COVID GenderTags :

Low Testosterone may be a Risk Factor for Severe COVID

On By ModernMedia
Testosterone molecule
Model of a testosterone molecule. Source: Wikimedia CC0

Among men with COVID, those with low testosterone levels are more likely to become seriously ill and be hospitalised than men with normal levels of the hormone, according to a study which appears in JAMA Network Open.

Analysis of data for 723 men who tested positive for COVID, mostly in 2020 before vaccines were available, indicated that low testosterone is an independent risk factor for COVID hospitalisation, similar to diabetes, heart disease and chronic lung disease.

They found that men with low testosterone who developed COVID were 2.4 times more likely to require hospitalisation than men with hormone levels in the normal range. Further, men who were once diagnosed with low testosterone but successfully treated with hormone replacement therapy were no more likely to be hospitalised for COVID than men whose testosterone levels had always tested in the normal range.

The findings, by researchers from the Washington University School of Medicine in St. Louis and Saint Louis University School of Medicine, suggest that treating men with low testosterone may help protect them against severe disease and reduce the burden on hospitals during COVID waves.

“It is very likely that COVID is here to stay,” said co-senior author Abhinav Diwan, MD, a professor of medicine at Washington University. “Hospitalizations with COVID are still a problem and will continue to be a problem because the virus keeps evolving new variants that escape immunization-based immunity. Low testosterone is very common; up to a third of men over 30 have it. Our study draws attention to this important risk factor and the need to address it as a strategy to lower hospitalisations.”

Prof Diwan and co-senior author Sandeep Dhindsa, MD, an endocrinologist at Saint Louis University, had previously shown that men hospitalised with COVID have abnormally low testosterone levels. However, severe illness or traumatic injury can cause a temporary drop in hormone levels, so causation cannot be proved in data from men already hospitalised with COVID. Data were needed for men with chronically low testosterone before COVID infection.

Profs Diwan, Dhindsa and colleagues identified 723 men whose testosterone levels had been measured between Jan. 1, 2017, and Dec. 31, 2021, and who had documented cases of COVID in 2020 or 2021. In some cases, testosterone levels were measured after the patient recovered from COVID. Since low testosterone is a chronic condition, men who tested low a few months after recovering from COVID probably had low levels before as well, Prof Dhindsa said.

The researchers identified 427 men with normal testosterone levels, 116 with low levels, and 180 who previously had low levels but were being successfully treated, meaning that they were on hormone replacement therapy and their testosterone levels were in the normal range at the time they developed COVID.

“Low testosterone turned out to be a risk factor for hospitalisation from COVID, and treatment of low testosterone helped to negate that risk,” Prof Dhindsa said. “The risk really takes off below a level of 200 nanograms per decilitre, with the normal range being 300 to 1000 nanograms per decilitre. This is independent of all other risk factors that we looked at: age, obesity or other health conditions. But those people who were on therapy, their risk was normal.”

Men with low testosterone levels can experience sexual dysfunction, depressed mood, irritability, difficulty with concentration and memory, fatigue, loss of muscular strength and a reduced sense of well-being overall. When a man’s quality of life is clearly diminished, he is typically treated with testosterone replacement therapy. When the symptoms are mild, though, doctors and patients may hesitate to treat.

The two main concerns related to testosterone therapy are an increased risk of prostate cancer and heart disease. Testosterone is well known to boost prostate cancer, but for heart disease, the evidence for risk is more ambiguous. A large clinical trial on the relationship between heart health and testosterone supplementation is expected to be completed soon.

“In the meantime, our study would suggest that it would be prudent to look at testosterone levels, especially in people who have symptoms of low testosterone, and then individualise care,” said Prof Diwan, whose specialty is cardiology. “If they are at really high risk of cardiovascular events, then the doctor could engage the patient in a discussion of the pros and cons of hormone replacement therapy, and perhaps lowering the risk of COVID hospitalisation could be on the list of potential benefits.”

Since this study is observational, it only suggests that boosting testosterone levels may help men avoid severe COVID, Diwan cautioned. A clinical trial would be needed to demonstrate conclusively whether such a strategy works.

Source: Washington University School of Medicine

Categories : COVID ExerciseTags :

Returning to Sport after COVID Infection

On By ModernMedia
Rugby players
Photo by Olga Guryanova

A first-of-its-kind study published in Scientific Reports has investigated how the immune system of elite student-athletes responded to the COVID virus. Unlike older adults with comorbidities, American Football players who were diagnosed with COVID were able to have their immune system back to its baseline after their CDC-recommended isolation period.

“When COVID really started moving out of control, we met with Neil Johannsen, an exercise physiologist at LSU, and the athletic trainers Derek Calvert and Jack Marucci, and we discussed what we could do to make sure our athletes remained healthy. We especially wanted to make sure that athletes were not at risk for secondary infections when they came back from isolation,” said Guillaume Spielmann, associate professor in LSU’s School of Kinesiology.

Isolation effective after COVID infection

“When the idea started for the research, we discussed why not turn something negative into a positive, and assist with the research to find some answers. If we can do things to understand the virus better, let’s do it,” said Jack Marucci, LSU’s Director of Athletic Training. “The student-athletes were willing to be a part of it.”

During that time at the start of the COVID pandemic, the CDC had recommended 14 days of isolation.

“There was a lot unknown during this time. We are looking at a population that are extremely close to each other during plays and during games. We wanted to make sure that since they are literally face-to-face with other players, that their salivary defences, their oral defences were pretty much intact and that that part of their immune system was not affected by the disease; that there were no long-lasting effects of the disease,” Assoc Proff Spielmann said.

Saliva samples were collected from 29 student-athletes in 2020, before a COVID vaccine. Fourteen were COVID positive and 15 had no history of infection. Of the 14, only six reported mild symptoms from the virus, the other eight were asymptomatic throughout the isolation period.

“Salivary immunity is extremely important to ensure that people don’t contract secondary infections, so when athletes are coming back we need to make sure they are as healthy as can be. We found that the isolation period was sufficient to restore the athletes’ salivary immunity to the level seen in non-infected players,” Assoc Prof Spielmann said.

Safely return to play after COVID

These findings suggested the student-athletes could safely return to practice and play football without a risk of secondary infection; that their immune system wasn’t at risk when playing the close contact sport.

“I was worried a bit about long-haulers and other more significant outcomes like the concerns for the development of myocarditis. Engaging in athletic activities at an elite level can be stressful on the body and you would want to arm yourselves with the best scientific information to help understand potential outcomes. This data helped to validate some of these decisions that were made. Providing a safe environment for your student-athletes is paramount and this helped that process along,” said Shelly Mullenix, LSU’s Senior Associate Athletics Director for Health & Wellness.

For this study, three graduate students also participated in the research.

“This kind of access is unique in Division I sports. You typically don’t have access to football players, so the fact that we have access is hugely instrumental as well,” Assoc Prof Spielmann said. “LSU is a great place for this field.”

“I think this COVID research is something that we are really proud to be a part of and contribute to finding answers to such a devastating virus,” Marucci said.

Assoc Prof Spielmann, an immunologist, researches the impact of stress on the immune system of elite and tactical athletes, including astronauts and fire fighters. But this study isn’t the first for Spielmann and LSU Athletics. They have worked together to study psychological and physiological health, along with performance measures in other student-athletes and sports teams. A new study will take a closer look at female athletes’ mental, physiological and immune resilience to stress.

Source: Louisiana State University

Categories : COVID Mental HealthTags :

Distressed Individuals were Strong on COVID Vaccination but Lax on Social Distancing

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COVID heat map. Photo by Giacomo Carra on Unsplash

During the COVID pandemic, individuals who were distressed, showing signs of anxiety or depression, were less likely to follow recommendations from the Centers for Disease Control and Prevention, yet they were more likely to get vaccinated than non-distressed peers.

The authors refer to this as differential distress: when people act safely in one aspect while disregarding safety in another, both in response to the same psychological distress. This creates a conundrum for those trying to determine how best to communicate risks and best practices to the public.

Their study of 810 people revealed that distress was less likely to affect older people either way, despite their higher risk for severe outcomes if infected with SARS-CoV-2. Reported in Frontiers in Psychology, the findings suggest that fear messaging, which is intended to scare people and can increase their levels of distress, may not be the most effective way to encourage people to change behaviours.

“These findings do not point to a straightforward public health messaging campaign,” said Professor Joel Myerson, study leader. “Instead, officials may have to consider more finely tailored messages for different populations in order to achieve best outcomes: more attention to CDC recommendations as well as more people getting vaccinated.”

In a previous study, the researchers looked at social distancing and hygiene behaviours across a range of demographics. The results suggested that distress was closely tied to the way people responded to recommendations about social distancing. People who were more distressed were less likely to observe social distancing recommendations, perhaps as a way to maintain social connections that can ease anxiety and depression.

In the latest work, researchers again asked people about their adherence to the latest CDC recommendations, including newer recommendations outlining when to wear a mask and suggesting that people avoid spending lots of time inside with others. The results showed similar correlations to the previous study among age, distress and behaviour changes.

In terms of public health and effective messaging, one of the most pressing issues to arise after publication of the first study was the introduction of vaccines and the perceptions around them. Looking at four categories, fully vaccinated; partially vaccinated; unvaccinated but likely to get one; unvaccinated and unlikely to get one, researchers found:

  • People who had been fully vaccinated were more likely than those who were partially vaccinated to have close interactions with others following their shots.
  • Relative to those who said they were unlikely to get vaccinated, those who said they were likely to do so thought their chance of infection was higher.
  • Depending on the person’s age, they responded differently to the same level of stress. Overall, for example, the higher level of distress someone had, the less likely they were to social distance, but the more likely they were to get vaccinated. Both of these correlations became weaker, however, as people aged.

Fear messaging that tries to scare people into following guidelines tends to be useful only for a one-time event, Green said. “Ostensibly, getting vaccinated should count as such an event.” But as breakthrough cases increase and boosters add up, vaccinations are no longer one and done; they are instead a series of events, spread out over more than a year.

Although fear-based messaging may encourage younger people to get vaccinated, it also weakens their resolve to mitigation behaviours like social distancing. Not doing both poses a greater breakthrough infection risk.

Messaging also becomes less effective as people age, just as they become more vulnerable to severe illness.

“Part of the solution to the problem of differential distress may be to avoid the distress altogether,” said Professor Leonard Green, study co-lead. This would entail forgoing the fear campaign. Instead, a gentler approach may be warranted. “Our previous work suggests that what really motivates many people to change behaviours for the better is considering how their actions can benefit, or harm, other people.”

Source: Washington University in St. Louis

Categories : COVID Mental HealthTags :

How COVID Skewed The Perception of Time

On By ModernMedia
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Many people can agree that an altered passage of time, known as “temporal disintegration” in psychiatric literature, was a common experience during the COVID pandemic, ranging from difficulty in keeping track of days of the week to feeling that the hours themselves rushed by or slowed down. Prior work linked these distortions to persistent negative mental outcomes such as depression and anxiety following trauma.

A new study, published in Psychological Trauma: Theory, Research, Practice, and Policy, documents how pervasive the experience was in the first six months of the pandemic. Pandemic-related secondary stresses such as daily COVID-related media exposure, school closures, lockdowns and financial difficulties were also found to be predictors of distortions in perceived time.

“Continuity between past experiences, present life and future hopes is critical to one’s well-being, and disruption of that synergy presents mental health challenges,” said corresponding author E. Alison Holman, UCI professor of nursing. “We were able to measure this in a nationally representative sample of Americans as they were experiencing a protracted collective trauma, which has never been done before. This study is the first to document the prevalence and early predictors of these time distortions. There are relatively new therapies that can be used to help people regain a more balanced sense of time, but if we don’t know who is in need of those services, we can’t provide that support.”

Researchers assessed results of responses regarding distorted time perceptions and other pandemic related experiences from a national sample of 5661 participants. Surveys were conducted during March 18-April 18, 2020 and Sept. 26-Oct. 26, 2020 with respondents who had completed a mental and physical health survey prior to the COVID outbreak.

“Given that distortions in time perception are a risk factor for mental health problems, our findings have potential implications for public health. We are now looking at temporal disintegration, loneliness, and mental health outcomes over 18 months into the pandemic,” Prof Holman said. “This will help us gain insight into how these common experiences during the pandemic work together, so we can better understand how to help people struggling with these challenges.”

Source: University of California – Irvine

Categories : COVID Metabolic DisordersTags :

Youth-onset Type 2 Diabetes Increased 77% During COVID Pandemic

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Published in The Journal of Pediatrics, a study reviewing medical records has found that new diagnoses of type 2 diabetes in children has surged 77% since the pandemic, accelerating a trend that is already a great concern for parents and healthcare professionals.

The new analysis documented the rise in cases with measures of increased body mass index (BMI) and higher blood glucose and haemoglobin A1c test results.

During the first year of the pandemic, medical records showed that more boys (55%) were diagnosed with type 2 diabetes than girls (45%), a reversal of the percentages during the pre-pandemic years.

In addition, during the pre-pandemic years, more patients were diagnosed while outpatients (57%) than during the pandemic year, when more were diagnosed and treated as inpatients (57%), suggesting greater severity.

Overall, the researchers found that 21% of the young people diagnosed presented with “metabolic decompensation,” of which the most serious symptoms include vomiting, lethargy, confusion and rapid breathing. Pre-pandemic, such symptoms occurred in only 9% of children with new-onset type 2 diabetes. Because the study involved a retrospective review of medical records, the investigators say there is a potential for inconsistencies in reporting or missing information.

“It used to be rare to hear about a child with type 2 diabetes, but its prevalence in adolescents has almost doubled in the past 20 years,” said Dr Kesley. “Type 2 diabetes is associated with rapidly progressive disease and early onset of complications and, unfortunately, was on the rise even prior to the COVID pandemic.”

Data suggests diagnoses of type 2 diabetes in children are increasing by 4 to 5% per year. The COVID pandemic introduced multiple challenges and increased attention to children with pre-existing disorders such as diabetes.

“In the spring of 2020 we were inundated with new youth-onset type 2 diabetes cases,” said Dr Kelsey. “We were used to seeing 50-60 new cases per year and that increased to more than 100 new cases in a year. Colleagues at other institutions were seeing the same thing, so we gathered a team of researchers to evaluate the frequency and severity of new cases during the first year of the pandemic compared to the mean of the prior two years. It was challenging because there is not a funded national registry for youth-onset type 2 diabetes, so this work was done with an enormous and voluntary effort of investigators across the country who are dedicated to treating diabetes in youth.

“To our knowledge, this is the first multicentre study to report the impact of the COVID pandemic on rates of newly diagnosed youth onset type 2 diabetes,” Dr Kesley said. “We found that the pandemic was associated with an increase in new type 2 diabetes cases compared to the two prior years, as well as an increase in proportion of youth presenting in metabolic decompensation.”

Contributing factors could be stem from the immense behavioural and environmental changes since the onset of the pandemic. Worldwide, children were enrolled in school virtually, extracurricular activities were limited and daily routines were adjusted to decrease the potential exposure to COVID. Consequences of this included increased screen time, unhealthy eating habits, decreased physical activity and poor sleep habits, which all have associations with increased BMI.

Whether COVID infection was the direct cause for the increase, or just associated with environmental changes and stressors during the pandemic is unclear. “Further studies are needed to determine whether this rise is limited to the United States and whether it will persist over time,” said Dr Kesley. “There is still a lot of work to be done.”

Source: EurekAlert!

Categories : COVID Expert OpinionTags :

COVID Risks a ‘Lost Generation’ for Psychiatry Research

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The field of psychiatry research risks a “lost generation” due to the difficulties of COVID, warn the authors of an editorial published in The Lancet. The burden of the pandemic has strained the critical aspect of the mentor-mentee relationship and the difficult period between the end of training and beginning research as an independent professional.

The authors, Erika E Forbes and David J Kupfer, are directors of the US-based Career Development Institute for Psychiatry, which provides teaching and mentoring programme for those embarking on a career into academic psychiatry, note that the pandemic has had a significant impact on this stage of development. The same challenges noted by the authors no doubt apply to the field of clinical psychology as well, which is also dependent on mentoring.

Both mentors and mentees are exhausted from health-related uncertainty, from Zoom meetings, and struggling to effectively collaborate, they wrote.

They note that starting a career as a scientist is a challenge even in the most stable times, but is now particularly gruelling, something they have recently borne witness to.

“At our April 2022 annual workshop, our fellows were dispirited, telling us that they feel neglected, undermined, and in some cases emotionally abused by the mentors at their home institutions. Many cannot envision a way forward.”

Though the authors are optimistic about adapting to COVID, with the limited of virtual settings and the new acknowledgement of how daily struggles impact work, they cannot deny that cannot deny that “psychiatry research is in a mentoring crisis.”

“There is a danger of losing a generation of talented, promising scientists, and this could stall progress in understanding and treating psychiatric illnesses,” they warn. To deal with this, mentors must still provide the “traditional elements of mentoring”, ie, guidance, advocacy, training, and access to professional networks, along with embracing technology and empathy. It is crucial to understand the mentee and provide them with more of the same basic support, because the usual challenges are amplified.

Mentoring is different in the COVID era, they stress. “If we accept that research will not go back to the pre-pandemic ways, adapt our behaviour to current realities, and enhance our commitment to supporting and guiding others, early-career scientists will again be able to thrive,” the authors conclude.

Categories : COVIDTags :

Trial Suggests Early Metformin is Effective in COVID Treatment

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In a study published in the New England Journal of Medicine, researchers have found that metformin, a commonly prescribed diabetes medication, lowers the odds of emergency department visits, hospitalisations, or death due to COVID by over 40%; and over 50% if prescribed early in onset of symptoms. The study also found no positive effect from treatment with either ivermectin or low-dose fluvoxamine.

“Our trial suggests that metformin may reduce the likelihood of needing to go to the emergency room or be hospitalised for COVID,” said Carolyn Bramante, MD, principal investigator of the study.

The primary outcome was in fact low oxygen on a home oxygen monitor, which none of the medications in the trial prevented.

The COVID-OUT trial studied whether metformin, low-doses of the antidepressant fluvoxamine, the controversial antiparasitic ivermectin, or their combinations could serve as possible treatments to prevent ER visits or hospitalisation, as well as Long COVID.

Patients were randomised to receive one of the three drugs individually: placebo, or a combination of metformin and fluvoxamine or metformin and ivermectin. Although the study was placebo-controlled with exact-matching placebo pills, Dr Bramante said that 83% of volunteers received medications supported by existing data because of the six-arm design. Each participant received 2 types of pills to keep their treatment assignment masked, for 3 to 14 days of treatment. Each volunteer tracked their symptoms, and after 14 days, they completed a survey.

The 1323 participants in the trial were limited to adults with a body mass index greater than or equal to 25 kg/m2, which qualifies as overweight. To qualify for the study, volunteers enrolled within three days after receiving a positive COVID test. It was among the first randomised clinical trials for COVID to include pregnant women.

The study included those who were vaccinated and those who were not. This is the first published trial where the majority of participants were vaccinated. 

“Although we know COVID vaccines are highly effective, we know that some new strains of the virus may evade immunity and vaccines may not be available worldwide. So we felt we should study safe, available and inexpensive outpatient treatment options as soon as possible,” said Dr Bramante. “Understanding whether outpatient treatments could ensure more people survive the illness if they contract it and have fewer long-term symptoms is an important piece of the pandemic response.”

The clinical trial launched in January 2021 after researchers noticed that outpatient metformin use appeared to decrease the likelihood of mortality from, or being hospitalised for COVID. Their research was published in the Journal of Medical Virology and in The Lancet Healthy Longevity. Test-tube studies also found that metformin inhibited the -CoV-2 in lab settings. These findings, along with additional prospective studies supporting the use of higher-dose fluvoxamine and ivermectin, provided the evidence to include all three medications as well as combination arms.

Source: University of Minnesota

Categories : Antibiotics COVIDTags :

The COVID Pandemic has Worsened Antimicrobial Resistance

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The COVID pandemic has set back years of progress against antimicrobial resistance, with resistant hospital-onset infections and deaths increasing by at least 15% in the first year of the pandemic alone, according to a new  report from the US CDC.

About 3 million people in the US are infected with antimicrobial-resistant pathogens, often acquired in healthcare settings, with about 50 000 people dying. Some estimates predict that by 2050, there could be more deaths from antibiotic resistance than from cancer.

Corrie Detweiler, a professor of molecular, cellular, and developmental biology at CU Boulder, has spent her career trying to develop solutions to antimicrobial-resistance. CU Boulder Today spoke with her about why so many antimicrobial drugs won’t work anymore, how COVID made things worse and what can be done to make things better.

Prior to the pandemic, how were we doing in addressing this issue?

“A lot of progress had been made, particularly in hospital-acquired infections, based on a better understanding of the problem and better guidelines about when to use antibiotics. Between 2012 and 2017, for instance, deaths from antimicrobial resistance fell by 18% overall and nearly 30% in hospitals. That all fell apart during COVID.”

Why? How did COVID spawn an uptick?

We didn’t know how to treat COVID, and, understandably, there was a fair amount of chaos in the medical system. People were using antibiotics more, often inappropriately. About 80% of COVID patients received antibiotics. People were given them prophylactically, prior to knowing they had a lung bacterial infection. That’s not to say that none of (the patients) needed them. Some did. But the more you use antibiotics, the more you select for resistance. And that’s how you eventually get a superbug. 

What can society do to address this? 

First, we need to go back to this idea of stewardship in hospitals – to only give out antibiotics when there is a clear need. We were doing the right thing. And then something terrible came along and messed it up, and it demonstrated that what we were doing was working well. That’s a good thing. Second, we need to discover and develop novel classes of antibiotics. The last time a new class of antibiotics hit the market was in 1984. The fundamental problem is that they’re not profitable to develop, compared to say a cancer drug. You can go to the drugstore and get a course of amoxicillin for $8. We need programs that reward industry and academic labs like ours for doing the early research.

What does your lab do?

We’re using basic biology to try to figure out new ways to kill bacteria during an infection and identify compounds that work differently than existing drugs. 

Source: University of Colorado

Categories : COVIDTags :

Long COVID Resulted in Long-term Increase in Health Service Use

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A US study published in JAMA Network Open found that COVID was associated with a 4% increase in use of health care services across that country over the six months after initial infection.

Long COVID is known to affect some COVID patients long after symptoms of the acute infection had subsided. The typical clinical symptoms in long COVID are tiredness, dyspnoea, fatigue, brain fogginess, autonomic dysfunction, headache, persistent loss of smell or taste, cough, depression, low-grade fevers, palpitations, dizziness, muscle pain, and joint pains. This study showed that the greatest increase in encounters for these patients was in virtual visits, followed by emergency department visits.

“This study showed us that, in terms of the number of follow-up visits, a substantial amount of health care utilisation occurs in the six months following the acute stage of SARS-CoV-2 infection, which highlights the potential for COVID to exert an ongoing demand  on health care organisations,” said epidemiologist Sara Y. Tartof, PhD, one of the study’s lead authors. “A 4% increase in encounters applied across a large population is a large number of visits associated with substantial cost. The absolute number is big. In this case, it was over 27 000 extra encounters among the eight health care organisations included in this study.”

Dr Tartof added: “On a broader scale, this study will help health care organisations develop their long-term strategic plans to meet patients’ needs following COVID infection.”

This study included patients of all ages from eight large integrated health care organizations across the US who completed a COVID diagnostic test between March 1 and November 1, 2020. Patients were matched on age, sex, race, ethnicity, site, and date of COVID test, and were followed for 6 months. The final matched study group consisted of 127 859 patients who tested positive for COVID-19 with an equal number testing negative.

  • Overall coronavirus infection was associated with a 4% increase in health care use over six months, predominantly for virtual encounters, followed by emergency department visits.
  • COVID-associated health care encounters for 18 conditions remained elevated 6 months from the acute stage of illness, with the largest increase in COVID-related utilisation including:
    • lingering COVID
    • alopecia, also known as hair loss
    • bronchitis
    • pulmonary embolism or deep vein thrombosis
    • difficulty breathing
  • In total, extra health care use associated with the effects of COVID infection consisted of 212.9 additional encounters per 1000 patients with COVID.
  • The study is one of the largest and most comprehensive studies of post-COVID utilisation among children under age 17.
  • COVID-positive children experienced increased health care use over six months for pulmonary embolism or deep vein thrombosis; irregular heartbeat; difficulty breathing; and ear, nose, and throat disorders.

“With complete data from all care settings across large integrated health care organisations, this study represents one of the largest and most comprehensive studies of post-COVID conditions to date,” said epidemiologist Debbie Malden, DPhil, another lead author.

Source: Kaiser Permanente

Categories : COVID PaediatricsTags :

Children’s Nasal Epithelium Protective against Older COVID Variants

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An Australian study published in PLOS Biology suggests the nasal epithelium of children inhibits infection and replication of the ancestral strain of the SARS-CoV-2 virus and also the Delta variant, but not the Omicron variant.

Children are in general less susceptible to COVID, with a lower infection rate and milder symptoms than adults. However, the factors driving this apparent paediatric resistance to COVID infections remained unknown.

In order to better understand infection and replication of SARS-CoV-2 in children, Kirsty Short at University of Queensland, and colleagues, obtained samples of primary nasal epithelium cells from twenty-three healthy children aged 2–11 and fifteen healthy adults aged 19–66 in Australia. They exposed the cells of adults and children to SARS-CoV-2 and then observed the infection kinetics and antiviral responses in children compared to adults.

The researchers found that ancestral SARS-CoV-2 replicated less efficiently and was associated with a heightened antiviral response in the nasal epithelial cells of children. This lower viral replication rate was also observed with the Delta variant, but not the Omicron variant.

Study limitations included a small sample size, so future clinical studies will be needed to validate these preliminary findings in a larger population and to determine the role of other factors, such as antibodies in protecting children from SARS-CoV-2 infection. Additionally, paediatric protection from emerging variants has yet to be quantified.

The authors wrote, “We have provided the first experimental evidence that the paediatric nasal epithelium may play an important role in reducing the susceptibility of children to SARS-CoV-2. The data strongly suggest that the nasal epithelium of children is distinct and that it may afford children some level of protection from ancestral SARS-CoV-2.”

Short added, “We use nasal epithelial cells from children and adults to show that the ancestral SARS-CoV-2 and Delta, but not Omicron, replicate less efficiently in paediatric nasal epithelial cells.”

Source: Science Daily