Category: COVID

Categories : COVID ImmunologyTags :

COVID did not get Weaker – Our Immune Systems got Stronger, Large Scale Study Suggests

On By ModernMedia
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Researchers have shown that the reduced mortality from COVID is not necessarily due to the fact that later variants, such as Omicron, have been less severe. Rather, the reduced mortality seems to be due to several other factors, such as immunity from previous vaccinations and previous infections. The study is published in the latest issue of Lancet Regional Health Europe.

The researchers at Karolinska Institutet, together with partners in the EuCARE project, conducted a study using patient data from more than 38 500 hospitalised patients with COVID, from the start of the pandemic to October 2022. The data comes from hospitals in ten countries, including two outside Europe.

The data showed that in-hospital mortality decreased as the pandemic progressed, especially since Omicron became the dominant variant. However, when the researchers modelled the mortality rates for different variants (pre-Alpha, Alpha, Delta and Omicron) and took into account factors such as age, gender, comorbidity, vaccination status and time period, they saw far fewer differences and weaker associations. They also saw differences between age groups, highlighting the importance of conducting separate analyses for different age groups. 

“Overall, our findings suggest that the observed reduction in mortality during the pandemic is due to multiple factors such as immunity from vaccination and previous infections, and not necessarily tangible differences in inherent severity,” says Pontus Hedberg, first author of the study. 

Omicron variant no less severe 

Understanding the disease course and outcomes of patients hospitalised with COVID during the pandemic is important to guide clinical practice and to understand and plan future resource use for COVID. A particularly interesting finding is that the inherent severity of Omicron has not necessarily been significantly reduced, but that other factors are behind the reduction in mortality. 

“The fact that Omicron can cause severe disease was seen in Hong Kong, for example, where the population had low immunity from previous infections and low vaccination coverage. In Hong Kong there was a relatively high mortality from Omicron,” says Pontus Hedberg. 

Highlights the importance of protecting the elderly and those with underlying diseases

The main applications of the study results going forward are the continued need to protect the elderly and patients with other underlying disease from severe disease outcomes through vaccination against COVID, even though new virus variants may appear less virulent. The results are also important for understanding trends in mortality in hospitalised patients with COVID and thus planning for resource use in hospital care.

Larger multinational collaborative projects like this are of great value to increase the generalisability of studies and not least to promote international collaboration also for future pandemic or epidemic scenarios.

Source: Karolinska Institutet

Categories : COVID ImmunologyTags :

Overactive Complement System Causes Long Covid

On By ModernMedia
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A new study from the University of Zurich (UZH) has revealed that the complement system plays an important role in Long Covid, a common sequela of SARS-CoV-2 infection. The findings, published in Science, show that the complement system ends up damaging tissue and blood cells even after the original infection has ended.

A significant proportion of individuals infected with SARS-CoV-2 develop long-lasting symptoms with a wide range of manifestations. The causes and disease mechanisms of Long Covid are still unknown, and there are no diagnostic tests or targeted treatments.

Part of the immune system active for too long

A team of researchers led by Onur Boyman, professor of immunology at UZH and Director of the Department of Immunology at the University Hospital Zurich (USZ), has implicated the complement system. It is part of the innate immune system and normally helps to fight infections and eliminate damaged and infected body cells.

“In patients with Long Covid, the complement system no longer returns to its basal state, but remains activated and, thus, also damages healthy body cells,” says Boyman.

Continued activation of complement system damages tissue and blood cells

The researchers followed 113 COVID patients for up to one year after their acute SARS-CoV-2 infection and compared them with 39 healthy controls.

After six months, 40 patients had active Long Covid disease.

More than 6500 proteins in the blood of the study participants were analysed both during the acute infection and six months later.

“The analyses of which proteins were altered in Long Covid confirmed the excessive activity of the complement system. Patients with active Long Covid disease also had elevated blood levels indicating damage to various body cells, including red blood cells, platelets and blood vessels,” explains Carlo Cervia-Hasler, a postdoctoral researcher in Boyman’s team and first author of the study.

Bioinformatics recognises protein patterns

The measurable changes in blood proteins in active Long Covid indicate an interaction between proteins of the complement system, which are involved in blood clotting and the repair of tissue damage and inflammation.

In contrast, the blood levels of Long Covid patients who recovered from the disease returned to normal within six months.

Active Long Covid is therefore characterised by the protein pattern in the blood.

The blood markers were discovered using bioinformatics methods in collaboration with Karsten Borgwardt during his time as a professor at ETH Zurich.

“Our work not only lays the foundation for better diagnosis, but also supports clinical research into substances that could be used to regulate the complement system. This opens up new avenues for the development of more targeted therapies for patients with Long Covid,” Onur Boyman said.

Source: University of Zurich

Categories : COVID VaccinesTags :

A Universal Coronavirus Vaccine could Save Millions of Lives in a Future Pandemic

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What if in the years prior to the COVID pandemic, scientists had developed a universal coronavirus vaccine, one that targets parts common to coronaviruses, offering some protection against all strains? Would it have been of help during the pandemic?

A new study suggests if such a vaccine were available at the start of the pandemic, it could have saved millions of lives, prevented suffering, and saved billions of dollars in direct medical and other costs until the strain-specific (ie, SARS-CoV-2) vaccine went through the entire development, testing, and emergency use authorisation process that lasted 10 months.

In this study, published in The Lancet’s eClinicalMedicine, researchers show that having a universal vaccine at the start of the pandemic would have had substantial health and economic benefits under almost all scenarios tested.

In order to determine the value of investing in developing and stockpiling a universal coronavirus vaccine, the team developed a computational model that simulated the entire US population, the introduction and spread of a novel coronavirus like SARS-CoV-2 in 2020 and the resulting health (eg, infections, hospitalisations) and economic (eg, direct medical costs, productivity losses) outcomes.

The experiments simulated what would happen if a universal coronavirus vaccine was available at the start of the COVID pandemic.

Vaccinating with a universal coronavirus vaccine as a standalone intervention (e.g., no face mask use or social distancing) was cost-saving even when its efficacy was as low as 10% and only 10% of the U.S. population received the vaccine.

For example, when a universal coronavirus vaccine has 10% efficacy, vaccinating a quarter of the U.S. population within two months of the start of the pandemic averts an average of 14.6 million infections and saves over $27 billion in direct medical costs.

Such low vaccine coverage at the start of the pandemic could occur if a vaccine were only made available to certain high-risk subpopulations (eg, 65 years and older, the immunocompromised, frontline workers), similar to the approach when mRNA vaccines became available in December 2020.

“COVID-19 was the third major and serious coronavirus epidemic or pandemic following SARS in 2002 and MERS in 2012, thus, we should anticipate a fourth coronavirus outbreak within the next decade or so,” says Peter J. Hotez, MD, PhD, dean of Baylor’s National School of Tropical Medicine and co-director of the Texas Children’s Hospital Center for Vaccine Development.

“A universal vaccine is cost-effective and cost-saving and a priority for advancement.”

A universal coronavirus vaccine was also shown to be highly cost-effective even if a more specific and more efficacious vaccine came to market.

For example, the study shows if it takes four months or longer for a strain-specific vaccine to reach the market, using a universal vaccine was still cost cost-saving.

In a scenario where a strain-specific vaccine has 90% efficacy but is unavailable for two months after the start of the pandemic, the results from the model show that vaccinating only 10% of the population with a universal vaccine that has 10% efficacy at the start of the pandemic can save over $2 billion in societal costs (eg, direct medical costs and productivity losses from absenteeism). Given the time required to develop a strain-specific vaccine during a pandemic to match circulating strains of the virus, this highlights the importance of having a universal vaccine readily available as a stopgap.

“Our study shows the importance of giving as many people as possible in a population at least some degree of immune protection as soon as possible,” explains Bruce Y. Lee, MD, MBA, executive director of PHICOR and professor at CUNY SPH.

“Having a universal vaccine developed, stockpiled, and ready to go in the event of a pandemic could be a game-changer even if a more specific vaccine could be developed three to four months later.”

Generally, results from the model found that a universal vaccine would end up saving money if the cost to get a person vaccinated (eg, cost of the vaccine itself, distribution, administration, storage, research, and development) is as high as $10 390 from a societal perspective.

Source: CUNY Graduate School of Public Health and Health Policy

Categories : COVIDTags :

Paxlovid does not Reduce Risk of Long COVID, Study Finds

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A recent has study found that Paxlovid (Nirmatrelvir-ritonavir) did not reduce the risk of developing long COVID for vaccinated, non-hospitalised individuals during their first COVID infection. The study also revealed a higher proportion of individuals with acute symptoms rebound and test-positivity than previously reported.

The study, by a team of researchers from UC San Francisco, is published in the Journal of Medical Virology.

Paxlovid treatment for acute COVID has been shown to be effective for high-risk unvaccinated individuals. But the effect of the treatment on long COVID risk, including whether it protects vaccinated people from getting long COVID, has been less clear.

The research team selected a group of vaccinated people from the UCSF Covid-19 Citizen Science study who had reported their first positive test for COVID-19 between March and August of 2022 and who were not hospitalised.

Some of these participants reported taking oral Paxlovid treatment during the acute phase of their COVID infection, while others did not.

In December of 2022, they were invited to answer a follow-up survey with questions about long COVID, COVID rebound symptoms and how long they continued to test positive.

Researchers found the two groups were similar. About 16% of those treated with Paxlovid had long COVID symptoms compared to 14% of those who were not treated with the medication.

Commonly reported symptoms included fatigue, shortness of breath, confusion, headache, and altered taste and smell.

Those who took Paxlovid and then went on to develop long COVID reported as many long COVID symptoms as those who were not treated with Paxlovid.

A small percentage of people developed severe long COVID, and those who had received Paxlovid were just as likely to have severe Long COVID symptoms as those who did not.

Among individuals who experienced symptomatic improvement during Paxlovid treatment, 21% reported rebound symptoms.

And among those with rebound symptoms, 10.8% reported one or more Long COVID symptom compared to 8.3% without rebound symptoms.

For participants who repeated antigen testing after testing negative and completing treatment, 25.7% reported rebound test positivity.

In total, 26.1% reported rebound symptoms or test positivity.

“We found a higher proportion with clinical rebound than previously reported but did not identify an effect of post-treatment rebound on long COVID symptoms,” said study first author Matthew Durstenfeld, MD, MAS, a cardiologist and UCSF assistant professor of Medicine.

“Our finding that Paxlovid treatment during acute infection is not associated with lower odds of long COVID surprised us, but it is consistent with two other rigorously conducted studies finding no difference in post-COVID conditions between 4 and 6 months after infection.”

The authors note that the study may have been impacted by limitations arising from its observational nature with researchers relying on patient self-reporting of treatment and Long COVID symptoms.

Source: University of California San Francisco Medical Center

Categories : COVID VaccinesTags :

Half Dose of COVID Booster Yields Similar Immune Response to Full One

On By ModernMedia
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Reducing the dose of a widely used COVID booster vaccine produces a similar immune response in adults to a full-dose with fewer side effects, according to a new study published in The Lancet Regional Health – Western Pacific. The research found that a half dose of a Pfizer COVID booster vaccine elicited a non-inferior immune response to a full dose in Mongolian adults who previously had AstraZeneca or Sinopharm COVID shots. But it found half-dose boosting may be less effective in adults primed with the Sputnik V COVID vaccine. 

The research, led by Murdoch Children’s Research Institute (MCRI) and the National Centre for Communicable Diseases in Mongolia, is part of an international clinical trial investigating the different COVID booster shot approaches to help guide future vaccination strategies. 

The first batch of findings, and involving 601 participants over 18 years old from Mongolia, reports on the initial responses seen 28-days after vaccination. The study is the first of its kind to assess and compare COVID-19 vaccines widely used in low- and middle-income countries.

MCRI Professor Kim Mulholland, who also sits on the WHO SAGE committee, said the study found that fractional doses elicited an immune response that was non-inferior to a full dose with fewer side effects and was less costly.

“Fractional dosing may improve COVID booster acceptability and uptake and reduce the per-dose cost of COVID-19 booster programs,” he said. “Policymakers and immunisation advisory committees can draw upon this data to make flexible boosting schedules decisions.”

The study found that participants receiving a half dose reported fewer local reactions than those receiving full doses (60% versus 72%) including less pain and tenderness. They also reported fewer systemic reactions (25% vs 32%) including less fevers, vomiting, diarrhoea and headaches. 

The cohort will be followed up at six and 12 months with the data to answer key questions on other aspects of the immune response including the rate of waning and breakthrough infections. 

Source: Murdoch Children’s Hospital

Categories : COVID Mental HealthTags :

Having Pets did not Result in Better Well-being During COVID

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Although pets are generally perceived as having a positive impact on well-being, a new study has found that there was no association between well-being and owning a pet during the COVID pandemic. This finding, published in the Personality and Social Psychology Bulletin, was in spite of pets owners reporting that pet ownership improved their lives.

There is a general understanding that pets have a positive impact on one’s well-being. A new study by Michigan State University found that although pet owners reported pets improving their lives, there was not a reliable association between pet ownership and well-being during the COVID-19 pandemic.

The study assessed 767 people over three periods in May 2020. The researchers took a mixed-method approach that allowed them to look at several indicators of well-being while also asking people in an open-ended question to reflect on the role of pets from their point of view. Pet owners reported that pets made them happy. They claimed pets helped them feel more positive emotions and provided affection and companionship. They also reported negative aspects of pet ownership like being worried about their pet’s well-being and having their pets interfere with working remotely.

However, when their happiness was compared to nonpet owners, the data showed no difference in the well-being of pet owners and nonpet owners over time. The researchers found that it did not matter what type of pet was owned, how many pets were owned or how close they were with their pet. The personalities of the owners were not a factor.

“People say that pets make them happy, but when we actually measure happiness, that doesn’t appear to be the case,” said William Chopik, an associate professor in MSU’s Department of Psychology and co-author of the study. “People see friends as lonely or wanting companionship, and they recommend getting a pet. But it’s unlikely that it’ll be as transformative as people think.”

The researchers explored several reasons why there is not a difference between the well-being of pet owners and nonpet owners. One of them being that nonpet owners may have filled their lives with a variety of other things that make them happy.

Source: Michigan State University

Categories : COVIDTags : 1 Comment

WHO Updates COVID Treatment Guidelines

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A panel of international experts representing the World Health Organization’s (WHO) Guideline Development Group has updated its guidance on treatments for patients with COVID.

The new recommendations published by The BMJ are part of a living guideline, developed by the WHO with the methodological support of MAGIC Evidence Ecosystem Foundation, to provide up to date, trustworthy guidance on the management of COVID and help doctors make better decisions with their patients.

The guidance incorporates the latest clinical trial evidence for existing and new COVID therapies and takes account of evidence relating to safety, prognosis, resources, access, and equity issues, as well as patient values and preferences. 

The updates include:

  • Distinct risk categories to help doctors more accurately assess whether an individual is at high, moderate, or low risk of hospital admission and tailor treatment accordingly.
  • A new treatment benefit threshold of 1.5% (down from 6%) reduction in the risk of hospital admission. This reflects the lower baseline risk for most patients with non-severe COVID as well as more safety evidence and wider availability of therapies.
  • A recommendation to use the antiviral drug nirmatrelvir-ritonavir in patients with non-severe COVID at high and moderate risk of hospital admission.
  • A recommendation against use of the antiviral drugs remdesivir and molnupiravir for patients with non-severe COVID at moderate and low risk of hospital admission (treatment is suggested for patients at high risk of admission).
  • A recommendation against use of a new antiviral (VV116) for patients with COVID except in clinical trials, regardless of illness severity.
  • A strong recommendation against the use of ivermectin for patients with non-severe COVID(advice against use of ivermectin in patients with severe or critical COVID, except in clinical trials, still exists).

The experts say the new recommendations reflect changes in the virulence and transmissibility of circulating SARS-CoV-2 variants and sub-variants, along with changes in immunity related to global vaccinations, which have led to lower baseline risks of severe illness and death for most patients with non-severe COVID.

They acknowledge that there are still uncertainties around COVID therapeutics and emerging evidence and say these recommendations need to be used in light of these uncertainties.

An interactive decision support tool is available to accompany this guidance.

Source: The BMJ

Categories : Allergies COVIDTags :

Pre-existing Allergies Increase Risk of Experiencing Long COVID Symptoms

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In an analysis of published prospective studies of people of all ages with confirmed SARS-CoV-2 infection who were followed for at least 12 months, pre-existing allergic conditions were linked to higher risks of experiencing long-term symptoms associated with COVID, or ‘Long COVID’.  

The analysis, which is published in Clinical & Experimental Allergy, identified 13 relevant studies (with a total of 9 967 participants) published between January 1, 2020 and January 19, 2023.

Although the data as a whole from the studies suggested that individuals with asthma or rhinitis might be at increased risk of long COVID after SARS-CoV-2 infection, the evidence for these associations was very uncertain. Therefore, more robust epidemiological research is needed to clarify the role of allergy in the development of Long COVID.

“We need a better, harmonised definition of what is considered Long COVID for epidemiological studies of this sort. Regardless we will be updating our analysis once further studies have been published in the next few months,” said corresponding author Christian Apfelbacher, PhD, of the Institute of Social Medicine and Health Systems Research, in Germany.

Source: Wiley

Categories : COVIDTags : 1 Comment

Why People in Japan are Still Wearing Masks after COVID

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When you think of Japan in the age of COVID, you might imagine a crowd of people wearing masks. But many of them are still wearing masks after the pandemic has ended. In an article published this month in the International Journal of Disaster Risk Reduction, a researcher from Osaka University analysed mask use before and after the government of Japan downgraded the legal status of COVID. Results showed that many people continue to wear masks for socio-psychological reasons – including reasons related to ‘relief’ and ‘norm’.

Of course, the obvious motivation for mask use is disease prevention. In the first half of 2020, masks were recommended worldwide because they help to prevent COVID transmission. Japan has since had one of the highest rates of mask usage throughout the pandemic.

However, on May 5, 2023, the World Health Organization declared the end of COVID as a global health emergency. Furthermore, on May 8, Japan downgraded the legal status of COVID to the same level as seasonal influenza.

Michio Murakami, the study’s author, notes, “The online survey shows that 59% of Japanese participants are still wearing masks, even after the downgrading of the legal status of COVID. That is only slightly down from 67%, which was before the downgrading.”

The surveys were conducted among people aged 20 to 69 in Japan. The first survey was performed in April 2023, before the policy changes, while the second was performed after the changes in June 2023. A total of 291 participants completed both surveys.

So what reasons, besides disease prevention, might lead people to continue wearing masks? “One common socio-psychological reason involves what we call ‘relief’. This means that wearing a mask can help relieve anxiety for many people,” explains Murakami. “There’s a second sociological reason, too: a ‘norm’. This refers to when people think they should wear a mask because they see others wearing masks,” he explains. People that have this trait are more likely to wear a mask when others around them are wearing masks, unsurprisingly.

Murakami was also able to document correlations between mask-usage motivations and actual mask usage. For instance, citing psychological reasons for mask use in April was correlated with actually wearing a mask later on in June. Furthermore, wearing a mask in April was associated with citing infection avoidance as a reason to wear masks in June.

“So many Japanese people prefer to wear masks,” notes Murakami. “This study helps us understand why people might do so, even in light of reduced infection risk.”

Source: Osaka University

Categories : COVID General InterestTags :

World-renowned Vaccinologist Shabir Madhi Awarded CBE

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Professor Shabir Madhi has been appointed as an honorary Commander of the Most Excellent Order of the British Empire (CBE) by King Charles III.

Wits Professor of  Vaccinology Shabir Madhi led the Oxford University sponsored Oxford/AstraZeneca Covid-19 vaccine clinical trials in South Africa

Wits University and the University of Oxford contributed scientifically to informing the public health response to the Covid-19 pandemic in South Africa and globally.

Madhi receives the Order in recognition of his services to science and public health in a global pandemic.

Madhi led South Africa and the continent’s first Covid-19 vaccine trials in 2020/2021 as founder and Director of the South African Medical Research Council (SAMRC) Wits Vaccines and Infectious Diseases Analytics (Wits VIDA) Research Unit.

An internationally recognised leader in his field, the National Research Foundation A-rated scientist was involved in multiple clinical and serology epidemiology studies on Covid-19, in addition to his research on vaccines against other life-threatening diseases.

The first of (subsequently two) Wits University-led South African Covid-19 vaccine trials, Madhi led the Oxford/AstraZeneca Covid-19 vaccine clinical trials in South Africa, in association with the University of Oxford.

Professor Sir Andrew Pollard, Director of the Oxford Vaccine Group, University of Oxford, and Madhi’s UK counterpart in these Covid-19 vaccine trials, says of Madhi’s CBE appointment: “I am delighted that Professor Shabir Madhi CBE has been honoured by King Charles for his remarkable contributions to global public health and particularly for his extraordinary leadership in the midst of a global pandemic. It has been a huge privilege for me to work alongside him and his team on the development of the globally impactful Oxford-AstraZeneca vaccine.”

Over the course of the pandemic (2020-2022), Madhi had been an outspoken, articulate, and ardent advocate of Covid-19 vaccination as well as for increased access to these and other vaccines in Africa.

On his appointment as CBE, Madhi says: “The privilege of being conferred this honour is credit to the tremendous effort of the incredible Wits VIDA research team that I have the privilege of leading at Wits University – before, during and beyond the Covid-19 pandemic. As a collective, and together with colleagues at the University of Oxford and in South Africa, we are proud to have contributed scientifically to informing the public health response to the Covid-19 pandemic in South Africa and globally.”

Source: Wits University