Category: COVID

Categories : COVIDTags :

Steroids Indicated Only for Most Severe COVID Patients

On By ModernMedia

According to new research, treating COVID patients with steroids to manage inflammation and stave off a cytokine storm may only be useful in patients with severe COVID.

Most patients with moderate to severe COVID in fact have a suppressed immune system, suggesting that treatment with steroids such as dexamethasone should only be applied to patients with most severe COVID. Severe COVID patients develop a hyperinflammatory reaction known as a cytokine storm.

The researchers measured cytokine levels in 168 adults with COVID, 26 with flu and 16 that were healthy volunteers. When dexamethasone or other steroids are administered to patients with already lowered immune system, they can backfire.

“We did identify a subset of Covid-19 patients with the broadly upregulated array of cytokines.. But, overall, the average person with Covid-19 had less inflammation than the average person with flu,” said study co-author Paul Thomas of St Jude Children’s Research Hospital.

The study authors thus believe that steroids should only be directed at the small subset of COVID patients with an overactive immune response. What they say is an urgent requirement now is a fast, reliable and cheap test to measure cytokines, thereby identifying those patients that are likely to benefit from dexamethasone.

Source: Times of India

Categories : COVIDTags :

New Study Shows Pollution May Accelerate COVID Spread

On By ModernMedia

A study from the McKelvey School of Engineering at Washington University shows that pollution may have contributed to the rapid spread of COVID through the United States.

The spread of COVID is directly associated with the long-term ambient level of PM2.5 (particles less 2.5 micrometres in diameter) and the reproduction number R0 for the coronavirus. PM2.5 are small enough to enter the lungs and cause damage. Matters are only worsened with secondary inorganic components in PM2.5.

Looking at 43 factors such as age, population density and time delays in lockdown orders, and comparing it to pollution statistics, they found a linear association with PM2.5 concentrations and inorganic components. Interestingly, this relationship only appeared above a certain level of air pollution.

“Annual mean PM2.5 national standards are set at or below 12 microgrammes per cubic metre, below that you are supposed to be safe,” said Rajan Chakrabarty, associate professor in the Department of Energy, Environmental & Chemical Engineering. “What we saw, the correlation we’re seeing is well below that standard.”

More detailed analysis showed that black carbon in the form of soot had a synergistic effect. “We found black carbon acts as a kind of catalyst. When there is soot present, PM2.5 has more of an acute effect on lung health, and therefore on R0.”

Source: Science Daily

Categories : COVIDTags :

Black Market for Negative COVID Tests

On By ModernMedia

According to Business Insider South Africa, falsified negative COVID tests are being used around the world, with even a black market for them existing.

In France, seven people were arrested when a traveller at Charles de Gaulle Airport was discovered trying to travel with a falsified negative COVID digital certificate. The fraudulent certificates were being sold for $180 (R2,800) to $360 (R5,600) each. In October, a group of travellers in Brazil faked their own COVID test results trying to get into the Fernando de Noronha island group. While in the UK, a number of people admitted altering the test results for friends, because the certificates were electronic and very simple to alter and then print.

Categories : COVID LungTags :

MRI Scans Reveal Post-COVID Extent of Lung Damage

On By ModernMedia

A study of non-hospitalised individuals who had recovered from COVID but still experienced breathing difficulties had revealed lung damage where other tests were unable to.

To investigate post-COVID lung damage, Prof Fergus Gleeson led a study involving 10 participants aged 19 to 69, of whom eight had been experiencing breathing difficulties three months after a COVID infection. They had not been hospitalised for their COVID, and conventional scans had not been able to detect any abnormalities with their lungs.

The patients’ lungs were imaged using magnetic resonance imaging (MRI) scans with xenon present in the lungs. Xenon, a noble gas, is non-toxic Xenon has a long history of use as a contrast agent, and is soluble with pulmonary tissue, allowing for investigation of specific lung characteristics that are connected to gas exchange and alveolar oxygenation, at the level of small airways where pulmonary function tests (PFTs) cannot provide information.

The scans revealed that there was indeed lung damage preventing alveolar oxygenation – and it was unexpectedly severe.

Prof Gleeson said, “I was expecting some form of lung damage, but not to the degree that we have seen.”

The findings help to explain the phenomenon of “long COVID”, where patients who have recovered from COVID continue to experience fatigue and breathing difficulties months after the original infection has ended.Based on the findings, Prof Gleeson will undertake a study with a further 100 participants based on the same criteria.

Source: BBC News 

Categories : COVIDTags :

No Lockdown May Worsen Economies

On By ModernMedia

In an article for The Conversation, Michael Smithson of the Australian National University argues that far from there being a toss-up between saving lives with a lockdown, and protecting the economy by keeping a country open, lockdown may in fact protect the economy.

Some arguments even leaned towards Indeed, US Treasury Secretary Steve Mnuchin said in June, “I think we’ve learned that if you shut down the economy, you’re going to create more damage.”

The choice of whether to implement lockdown has been a particularly difficult choice to make for South Africa, beset by deep inequality. Its lockdown caused its economy to shrink by 51% in the second quarter.

Economic and COVID data from 45 countries was sourced for analysis. The data has two outliers; namely China, which implemented a very effective early lockdown, and India, which implemented a strict lockdown that became very ineffective as time went by.

Consumer expenditure, an important indicator of economic activity, was negatively correlated with COVID cases, indicating that the economy fared better with attempts to suppress the virus (at least temporarily).

In European countries, GDP was positively correlated with COVID cases, indicating that economic activity itself drove up the rate of COVID cases. 

The article’s conclusions do have some limitations. The economic data were drawn from the second quarter, and COVID cases were taken as of June 30, but the pandemic hit different countries at different times. 

Categories : COVIDTags :

Gauteng to Brace for Second COVID Wave in January

On By ModernMedia

Speaking at a memorial for healthcare workers who have died from COVID, acting MEC of Health Jacob Mamabolo says that the Gauteng health department is expecting a second wave of the virus in January.

Gauteng, which represents 30.1% of all cumulative COVID cases nationwide, is expected to see a resurgence on the back of holiday festivities and travel, based on modelling information supplied to the provincial command council.

“We need to be reminded that the battle with Covid-19 is not yet over. We are still in the outbreak stage and not in the post-Covid-19 period yet. Here in Tshwane we still have hotspots and areas that are of great worry such as Atteridgeville, Sunnyside, Ga-Rankuwa and Mamelodi,” said Mamabolo.

He further added that alcohol consumption would lead to people being discouraged in following the COVID health and safety rules, and that staff were already exhausted from a long year of fighting the disease. He added that it was necessary that extra staff were approved for the fight in the coming year.    Source: Rekord East

Categories : COVID VaccinesTags :

Questions Raised over Oxford’s Unusual Vaccine Regimen

On By ModernMedia

The recent announcement of the Oxford’s and AstraZeneca’s vaccine trial being 70% effective up to 90% effective has raised some pointed questions.

The trial had two treatment arms, one receiving two full doses of the AZD1222 vaccine and a half dose plus a full dose, with the doses being administered 28 days apart. The “half dose then full dose”  treatment arm reported the 90% protection. The problem was that the trial was never meant to have such an arm. 

It was noticed that some participants were only receiving a half dose because they were experiencing fewer effects than expected such as arm pain and headache. This was subsequently corrected so that they would still receive the full dose on the second administration.

Of particular concern is that the “90% effectiveness” is based on a much smaller subset of the trial participants, with a correspondingly higher statistical uncertainty. So much so that there is statistical overlap with their lower effectiveness of 62% quoted for the two full doses. Furthermore, the participants were from the initial stages of the vaccine trial, where they were aged 18-55 and therefore have little applicability to the results of the main trial which included older age groups as well. 

The details of exactly why the half-measure doses came to be administered in the first place have not been revealed by Oxford or AstraZeneca. Meanwhile in the US, a Phase III of the trial is being rolled out with 40 000 participants, and the “half dose then full dose” regimen may be included – however, uncertainty about it and whether it isn’t a statistical fluke will have to be cleared up first.

Source: Ars Technica

Categories : COVID Expert OpinionTags :

AI Solutions Are No Magic Bullet Against COVID

On By ModernMedia

A leading researcher in the field of medical image analysis has cautioned against the rush to provide AI solutions to the COVID pandemic, arguing that the need to help out must not compromise scientific principles.

Prof Hamid Tizhoosh, head of KIMIA Lab, Faculty of Engineering at the University of Waterloo wrote a piece on Medical-News.Net where he laid out the problems involved in such “quick fix” solutions.

He explains that AI researchers often make “toy” datasets which they use to experiment with in their own labs. In the middle of the pandemic, it is difficult to collaborate with radiographers who have their hands full dealing with COVID patients’ images.

AI research requires the acquisition and curation of large amounts of high-quality data, and currently there is an absence of this. While there are still few publicly available X-ray images or CT images of COVID patients’ lungs, they are beginning to crop up on the internet. AI researchers and enthusiasts are scraping together these images for their data sets and supplementing them with those of pneumonia patients, which are much more readily available. The results of their AI work are being released in papers that are not peer reviewed, yet some claim to be authoritative solutions.

Tizhoosh draws attention to the validity of this data. In one instance, he saw that the data included a pneumonia case from a paediatric patient. He cautions that, “AI is neither a ventilator nor a vaccine nor a pill; it is extremely unlikely that the exhausted radiologists in Wuhan, Qom or Bergamo download the Python code of our poorly trained network (using insufficient and improper data and described in quickly written papers and blogs) to just obtain a flawed second opinion.”

He concludes that the AI developments must come after appropriate images are made available by hospitals, that ethics approval is received and the data is properly de-identified.

Categories : COVID Medical IndustryTags :

Netcare CEO Recounts Challenges and Lessons of 2020

On By ModernMedia

In an interview posted on Moneyweb, the CEO of Netcare, Dr Richard Friedland, related how the company had weathered a very hard financial year.

“We have certainly felt the effects financially and we haven’t been able to pay a dividend to shareholders. But, as I’ve said to all of our frontline workers, we paid a dividend to South Africa in terms of looking after so many thousands – more than 28 000 Covid patients. That is far more significant than anything we could have done in monetary terms,” said Friedland.

The company learned valuable lessons, being at “the tip of the spear” of the COVID pandemic. Following their first cases on March 9, a large outbreak occurred at St Augustine’s, followed by a much smaller one at Kingsway. 

Friedland spoke of the sacrifices the staff had made over the past months, saying “This is not a time to abandon them. It’s a time to stand with them. It does mean our recovery will be longer, but we’ll do that together. And I think it’s critically important, given the headwinds we’re facing in South Africa.”

The company made much of its profit from asset disposal, but Friedland said that they were seeing a return to demands for elective surgery, excepting their two hospitals in the Nelson Mandela Bay area. He noted that there was a noticeable uptick in cases, similar to what they had experienced in the first wave, and that their hospitals were relatively full. However, they were putting their lessons learned into practice by having readied adequate stores of PPE and oxygen, for example. The length of stay has been reduced from 22 days to seven. He remarked on how stressful the pandemic had been for all concerned, but he said that continued efforts must be made.

“[…]Covid nearly robbed us of our humanity, and we need to be very careful about that going forward, particularly as healthcare workers, when patients cannot see their loved ones, when they’ve got to communicate with us through masks and spaces. We’ve managed to find other ways, through Facetime and mobiles, to communicate with their loved ones; but there’s no excuse for [not] improving communication all the time. I think Covid exposed that and there’s been a lot of anxiety as a result that we still need to manage,” concluded Friedland.

Categories : COVIDTags :

SA Medicinal Plants Show a COVID Treatment Promise in New Study

On By ModernMedia

Researchers at the Durban University of Technology and the University of KwaZulu-Natal have been examining plants used in traditional African medicine to see if they have any application in treating COVID.

There has been increasing interest in investigating medicinal plants for compounds to use in the treatment of COVID, which still lacks an effective treatment despite effective vaccines being demonstrated.

The researchers began with 29 compounds from medicinal plants known to be effective in treating the common cold, flu, other respiratory conditions, as well as their antimalarial, antiviral and antioxidant activity.

Using a biocomputational approach that does simulated “molecular docking” with various compounds and the known molecules of SARS-CoV-2, the researchers found a number of plants, including the Rooibos bush, contained useful compounds. These displayed favourable binding orientations and were thus identified as being potential inhibitors of the SARS-CoV-2 receptor binding domain and SARS-CoV-2 RNA-dependent polymerase. Four compounds showed extremely good binding to the virus, indicating that they may prevent viral replication.

The next stage of their work will be an in vitro study, before moving onto animal models but is contingent on the team being able to secure funding.

Source: The Conversation