Category: Diseases, Syndromes and Conditions

Microbes Develop Resistance to Disinfectant Too, Warns UFS Professor

News-Medical.Net interviewed Professor Robert Bragg of the University of the Free State on the topic of pathogens, particularly bacteria, developing resistance to common disinfectants.

Professor Robert Bragg said that the control of diseases rests on three pillars: 1) vaccinations and vaccines, 2) treatment options (such as antibiotics for bacterial diseases), and 3) biosecurity.

Proff Brage explained that 10 to 15 years ago, there was an assumption that bacteria would not evolve resistance against disinfectants, but the COVID pandemic prompted a rethink. Now, disinfectant resistance is being looked at in the same light as antibiotic resistance. Biosecurity, he said, is ensuring that individuals do not come into contact with the pathogens in the first place. This is easily seen in the COVID pandemic, where face masks are worn (with a protection against contracting the disease of up to 70%), social distancing is enforced and hands and surfaces are sanitised. Though Prof Bragg’s main area of research is not antibiotic resistance, he notes that, “There are resistance mechanisms that are shared between antibiotics and disinfectants and we are looking at how these mechanisms increase resistance to disinfectants.” 

The protection of antibiotics is something taken for granted, but although mostly easily treatable (for now), bacteria can spread much faster than viruses, which require cells to reproduce in and whose re[plication rate is measured in days. “A common well-known bacterium such as Escherichia coli has a doubling time of around 20 min under ideal conditions. In other words, it only takes just 20 minutes for a population of E. coli to go from 1 million to 2 million and another 20 mins to reach 4 million, and so on,” Prof Bragg said. In the post-antibiotic era, there would be some treatment options such as bacteriophages, but for livestock the best protection would be biosecurity. However, disinfectant resistance would reduce the effectiveness of that option.

His research team has conducted a number of studies into the mechanisms of bacterial disinfectant resistance. “My research team has been working on various aspects of efficacy and resistance to disinfectants for quite some time and we have various projects that are currently underway,” he said. “Recently we identified a highly resistant strain of a Serratia species of bacteria. This strain was substantially more resistant to many different disinfectants than the reference strain. This great difference in the levels of susceptibility has allowed us to investigate various possible research mechanisms and also to look for possible novel resistance mechanisms.”

One of his team’s discoveries was that this highly resistant bacteria strain could grow on disinfectant if it was the sole source of carbon. Other areas of research around the resistant strain include sequencing and analysis of its genome, the role of bacterial efflux pumps removing disinfectant, and the role of plasmids (vehicles of genetic transfer between bacteria) in resistance and whether they are transferrable.

With regard to viruses, there are two kinds of viruses, enveloped and naked, and disinfectant has different effects on them. Enveloped viruses such as SARS-CoV-2, have a lipid layer picked up from their host cell, and are easy to kill with simple disinfectants because they break up the lipid layer, killing the cell. Naked cells are much harder to kill, and the few disinfectants that work against them are thought to do so by somehow disrupting the virus’ receptors.

One sanitiser of concern is alcohol, where 70% is considered optimal. However, people believe that ‘more is better’, yet increasing the alcohol percentage actually makes it evaporate faster, reducing contact time and thus leaving more of the virus behind. Similarly, some sanitisers include low levels of other disinfectant substances which are below the minimum threshold to kill the pathogens. This can leave surviving bacteria to develop resistance against these other sanitisers.

Prof Bragg advised that the public should purchase and use sanitisers prudently, following their instructions for use appropriately, and preferably checking to see if they are registered. He also cautioned

Source: News-Medical.Net

International Travellers at Risk of MDR Bacteria

International travellers are at risk of picking up a number of drug-resistant pathogens, according to a new European study.

In the COVID pandemic, international travel has become a distant memory for most of those used to it. As restrictions are lifted and international travel resumes, travellers are still at risk from other dangerous pathogens. In recent years, the rise of intestinal multidrug resistant gram-negative (MDR-GN) bacteria around the world poses a serious health threat, with MDR clones of E.coli and Klebsiella pneumoniae threatening more antibiotic resistant infections around the world. The spread of MDR-GN is a known threat in long-term care facilities, with residents forming a reservoir for the microbes but is also common in international travel as well. It is well documented that international travel results in the spread of multidrug-resistant E. coli, with up to 80% of travellers returning from high-risk regions being colonised by MDR-GN bacteria for up to a year. However, the existing research only compared participants before and after travel. A group of researchers from Universities of Basel, Birmingham, Helsinki and Oslo, and the Wellcome Sanger Institute set out to investigate the spread of such bacteria on a day by day basis.

Over a period of three weeks, the researchers monitored the health of a group of European travellers in the Lao People’s Democratic Republic by analysing daily information returns and stool samples. They found that by the end of the study period, 70% of the travellers had been colonised. The bacterial strains colonised travellers staying at the same hotel and spending time in one another’s company. In one case, a participant was colonised by taking a shower in another’s bathroom.

“International travel is strongly linked to the spread of MDR-GN bacteria, with transmission highest in India and Southeast Asia, Africa and South America,” said senior study author Professor Alan McNally, University of Birmingham. “Travellers visiting these high-risk regions are at substantial risk of acquiring the bacteria. Colonisation by MDR-GN bacteria is a highly dynamic process. We found constant ‘competition’ between circulating strains acquired by individual hosts and the travelers’ ‘native’ bacteria. Travellers can pick up the bacteria even during short visits and further spread the strains after returning home.”

All of the participants had acquired extended-spectrum beta-lactamases (ESBL) during their stay in Laos. ESBL enzymes create resistance within the body to most beta-lactam antibiotics, including penicillins, cephalosporins, and aztreonam. Infections with ESBL-producing organisms have proved difficult to treat. Also, all but one participant acquired multiple strains of bacteria with 83 unique strains identified (53 E. coli, 10 Klebsiella, 20 other ESBL-GN species), with up to four other participants sharing strains.

Study co-senior author, Professor Jukka Corander, at the University of Oslo and the Wellcome Sanger Institute, commented: “Our study reveals the true scale and complexity at which drug-resistant bacteria colonise the intestinal tract during travel, demonstrating that it has been seriously underestimated previously.

“In addition, several of our participants lost some of their travel-acquired ESBL-GN strains while still abroad – indicating that previous studies solely employing pre- and post-travel sampling have under-reported the extent to which travellers are colonised by ESBL-GN.”

Source: News-Medical.Net

Journal information: Kantele, A., et al. (2021) Dynamics of intestinal multidrug-resistant bacteria colonisation contracted by visitors to a high-endemic setting: a prospective, daily, real-time sampling study. The Lancet Microbe. doi.org/10.1016/S2666-5247(20)30224-X.

Researchers Say New Vaccines Needed for Childhood Pneumonia


Research in Australia on new pneumonia vaccines show that while pneumonia in children is being suppressed,  empyaema is increased.

The research, which was led by the University of New South Wales (UNSW), examined the impact of the new 13-valent pneumococcal conjugate vaccine (13vPCV) on childhood pneumonia and empyaema.
Empyaema, which is the collection of pus in the lungs, occurs in about 1% of children with pneumonia. In children, empyaema is far less fatal than it is in adults, but it does extend hospitalisation, requiring antibiotics and surgery or installation of a drain.
The findings of the study showed that while 13vPCV resulted in a 21% drop in childhood pneumonia hospitalisations, there was a contemporaneous 25% rise in empyaema hospitalisations.

According to senior author Professor Adam Jaffe, Head of the School of Women’s and Children’s Health at UNSW Medicine & Health, said the findings suggested an emergence of non-vaccine serotypes—those which 13vPCV does not cover.

13vPCV was introduced to cover the 13 most common serotypes that cause invasive pneumococcal infection, adding six more serotypes over the seven serotypes covered by its predecessor, 7cPCV.

Prof Jaffe said: “Although we found a substantial reduction in serotype 1, serotype 3 is now the predominant organism which causes childhood empyema—in 76% of cases—so, efforts must be made to create a vaccine which is more effective against serotype 3.

“In fact, Australia recently changed the vaccination dosage schedule to try and improve the effectiveness of 13vPCV against serotype 3, but we need to continue monitoring patients using molecular techniques to see if this change has had an impact.

“Childhood bacterial pneumonia and empyema are potentially preventable diseases through vaccination. So, if Australia can develop an effective vaccine, we could prevent children from being hospitalized with pneumonia and empyema.”

The researchers conducted a similar study over four years during the 7vPCV era.   

“Our new study had two parts,” Prof Jaffe said. “We analysed national hospitalisations for childhood empyaema and childhood pneumonia, then we conducted an enhanced surveillance study on children with empyaema.”

The first part of the research used publicly available hospitalisations data to find out if the introduction of 13vPCV changed how many children were admitted to hospital with pneumonia and empyaema.

The enhanced surveillance study involved the collection of blood and lung fluid samples from 401 children  with empyaema, followed by molecular testing on these samples and comparing the results to their previous study undertaken during the period of 7vPCV.

Prof Jaffe said research with a larger sample was ongoing, and 13vPCV monitoring was needed.

Source: Medical Xpress

Journal information: Roxanne Strachan et al. Assessing the impact of the 13 valent pneumococcal vaccine on childhood empyema in Australia, Thorax (2021). DOI: 10.1136/thoraxjnl-2020-216032

Russia Reports Bird Flu Transmission to Humans

On Saturday, Russia announced that it had detected the first case of the H5N8 strain of bird flu in humans.

The head of Russia’s health watchdog Rospotrebnadzor, Anna Popova, made the announcement in televised remarks. Scientists at the Vektor laboratory had identified the strain in seven workers at a Southern Russia poultry farm which had experienced an outbreak among the birds in December. No serious health consequences among the workers had been reported, and they are believed to have contracted the virus from the birds on the farm. The World Health Organization had already been alerted to the situation soon before the announcement.

Humans can contract bird flu A(H5N1) and A(H7N9) and swine flu subtypes such as A(H1N1). The bird flu subtype H5N1 is particularly dangerous as it has a 60% mortality rate in humans. According to the WHO, direct transmission between humans of such diseases is limited, and that most transmission comes when humans are in close contact with animals.

Influenza viruses are known to evolve “quite quickly” said Gwenael Vourc’h, head of research at France’s National Institute for Agriculture, Food, and Environment.

She added that there were likely cases outside Russia, saying to the FTP that this “is probably the tip of the iceberg.”

However, Francois Renaud, a researcher at the French National Centre for Scientific Research (CNRS), said that he was “not particularly worried” at this stage as the COVID pandemic had taught countries to react quickly, and that “draconian measures” will be taken to curb the outbreak.

He added that the coronavirus pandemic had taught countries to react quickly to potential health threats. “Draconian measures will be taken to immediately stop the outbreak,” he said.

Avian flu has raged in several European countries including France, where hundreds of thousands of birds have been culled to stop the infection.

The Vektor State Virology and Biotechnology Centre, which picked up the transmission to the poultry farm workers, also developed one of Russia’s coronavirus vaccines. The lab once conducted secret bioweapons research in the Soviet era, and still maintains stockpiles of viruses ranging from Ebola to smallpox.

Vektor chief Rinat Maksyutov said the lab was ready to begin the development of test kits to detect H5N8 in humans, and also to commence working on a vaccine.

Source: Medical Xpress

Novel Magnetic Technique Detects Malaria in Blood

A new magnetic method has been developed that can detect malaria, leading to faster, accurate and cheap diagnosis of the deadly disease.

An international study field-tested this new tool in Papua New-Guinea, in the hopes of helping the fight against this disease, which had 229 million reported cases in 2019, with 700 000 deaths a year.

“Malaria is easily treated but it is actually hard to diagnose, and because of that there can be over-treatment, which we have seen can lead to the spread of drug-resistant malaria,” said Dr Stephan Karl, a Senior Research Fellow in Malaria and Vector Biology at James Cook University’s Australian Institute of Tropical Health and Medicine.

“Improving malaria diagnosis, especially through the development of practical methods for resource-limited places, is important and timely,” he said.

An international team including the University of Augsburg’s Professor Istvan Kezsmarki, with the PNG Institute of Medical Research and the Burnet Institute, came up with the magnetic detection method, called rotating-crystal magneto-optical detection (RMOD).

When malaria parasites break down blood, the haeme molecules are aggregated by the parasites into biocrystals called haemezoin, which contain magnetic iron. This iron can is detectable by the RMOD method.

“I’ve studied the magnetic properties of malaria infected blood since 2006, and we engaged with Professor Kezsmarki’s team in 2013 to demonstrate the sensitivity of this test using human malaria parasites,” Dr Karl said.

A field study was successfully conducted, involving almost 1000 suspected malaria patients in a high-transmission area of Papua New-Guinea.

“After years of in-lab optimisation of the device, in collaboration with Dr. Karl we demonstrated the great potential of RMOD in fast and reliable malaria field tests performed in Papua New-Guinea,” Prof Kezsmarki said.

“We showed that RMOD performs well in comparison to the most reliable existing method..It’s very promising, as RMOD testing can be conducted after a short training session and provides test results within 10 minutes. From a funding perspective the cost is very low since no expensive reagents are used,” said Dr Karl.

Dr Karl said the aim was to refine the design until a test could be done by a simple button push.

Source: Medical Xpress

Journal information: L. Arndt et al, Magneto-optical diagnosis of symptomatic malaria in Papua New Guinea, Nature Communications (2021). DOI: 10.1038/s41467-021-21110-w

TB Vaccine Shown to Protect Against Common Infections

The tuberculosis (TB) vaccine Bacillus Calmette-Guerin (BCG) could protect newborns against a variety of common infections, such as upper respiratory tract infections, chest infections, and diarrhoea, according to a new study from the London School of Hygiene and Tropical Medicine (LSHTM).

It has been known that BCG protects against diseases other than TB, offering protection against non-tuberculous mycobacteria infection like leprosy and Buruli ulcer. It is also used in the treatment of superficial carcinoma of the bladder.

However, this is the first research to rigorously investigate the full range. The results suggest that vaccinating all babies with BCG on their day of birth could save lives by reducing neonatal infections in areas with high rates of infectious disease.

The study involved a randomised control trial of 560 newborns in Uganda, who were monitored for a range of illnesses. After six weeks, infection rates from any disease were 25% lower in the group that received the vaccine at birth, compared to the group that had not yet received the vaccination. The most protected appeared to be vulnerable groups such as low birth weight babies, and boys. Importantly, BCG appeared to protect against even severe infections.

Sarah Prentice, the lead author from LSHTM, said: “Nearly a million babies die every year of common infections so we urgently need better ways to protect them. Our research suggests that ensuring that BCG is given at birth could make a big difference in low-income countries, potentially saving many lives.”

The newborns were randomly assigned to receive BCG either at birth or at six weeks of age. They were followed-up by doctors, blinded to the intervention, for 10 weeks, who looked for any type of illness or infection.

The research team then compared how often infants in the two groups presented to doctors with infections of any kind, except TB, to see whether having BCG made a difference. They also took blood samples from both groups, to look at differences in their innate immune system, the body’s first line of defense against infections.

Infants vaccinated with BCG at birth presented to doctors with any kind of infection 25% less often than infants who had not. BCG seemed to protect against all kinds of infections, such as common colds, chest infections, and skin infections.

After the delayed group had been vaccinated, the rates of infection were identical between the two groups: the delayed group’s immunity ‘brought up to speed’ when they received BCG.

Study co-author Prof Hazel Dockrell, LSHTM, said: “It’s very exciting to think that BCG vaccination might help keep newborns safe against other dangerous infections, in addition to providing protection against TB. Although BCG is recommended at birth in many countries, it is often delayed due to logistical difficulties. Ensuring that the vaccine is given on day one, in areas with high rates of infectious disease, could have a major impact on infections and deaths in the newborn period.”

Though the study could not definitely determine whether the BCG vaccine was responsible for the lowered rate of infections, there is nonetheless great interest in applying the vaccine as a protection for novel disease outbreaks, such as COVID or Ebola, before a specific vaccine can be developed.

Dr Prentice said, “Since the findings show that BCG seems to offer wider protection against a range of infections, our study also raises hopes it might be useful in protecting the general population against COVID-19 and future pandemics – though we will need to see the results of other, more specific studies to know for sure.”

Source: News-Medical.Net

Journal information: Prentice, S., et al. (2021) BCG-induced non-specific effects on heterologous infectious disease in Ugandan neonates: an investigator-blind randomised controlled trial. The Lancet Infectious Diseases. doi.org/10.1016/S1473-3099(20)30653-8.

Excessive False Positives from SNP Testing in Very Rare Diseases

A widely-used genetic testing technology has a very high rate of false positives for extremely rare genetic diseases, a study has found.

Single nucleotide polymorphism (SNP) chips are DNA microarrays which test genetic variation at hundreds of thousands of specific genome locations. They were initially developed to study common genetic variations, and are excellent tools for tracing ancestry and aso detecting predisposition to common multifactorial diseases such as type 2 diabetes.

Prompted by accounts of women scheduling surgery because of wrongly being informed they had variations in the BRCA1 gene that could lead to very high risks of breast disease, a team from the University of Exeter set out to test the technology. Using data from 50 000 individuals, they found that the majority of rare disease detections were false.

“SNP chips are fantastic at detecting common genetic variants, yet we have to recognise that tests that perform well in one scenario are not necessarily applicable to others,” said senior author Caroline Wright, Professor in Genomic Medicine at the University of Exeter Medical School. “We’ve confirmed that SNP chips are extremely poor at detecting very rare disease-causing genetic variants, often giving false positive results that can have profound clinical impact. These false results had been used to schedule invasive medical procedures that were both unnecessary and unwarranted.”

The team compared data from the SNP chips to data from the UK Biobank which was sequenced with better technology, plus 21 volunteers sharing their consumer genetic data.

They found a false positive rate of 84% for variants that were 1 in 100 000. From the consumer data, 20 of the 21 had at least one false positive for a disease-causing variation.

Co-author Dr Leigh Jackson, Lecturer in Genomic Medicine at the University of Exeter, said the number of such false positives on SNP chips was “shockingly high.”

“To be clear: a very rare, disease-causing variant detected using a SNP chip is more likely to be wrong than right,” said Dr Jackson. “Although some consumer genomics companies perform sequencing to validate important results before releasing them to consumers, most consumers also download their ‘raw’ SNP chip data for secondary analysis, and this raw data still contain these incorrect results. The implications of our findings are very simple: SNP chips perform poorly for detecting very rare genetic variants and the results should never be used to guide a patient’s medical care, unless they have been validated.”

Source: Medical Xpress

Journal information: BMJ (2021). www.bmj.com/content/372/bmj.n214

Treating Periodontitis can Reduce Risks of Certain Other Diseases

A steadily growing body of evidence points to a two-way connection between oral health and systemic disease.

Periodontitis, the inflammation and disease of tissues surrounding the teeth, is already known to be a result of type 2 diabetes, but there is research to suggest that it may also cause diabetes—as well as certain other diseases.

“What happens in your body impacts your mouth, and that in turn impacts your body. It’s truly a cycle of life,” said Professor Purnima Kumar of The Ohio State University. “What is more dynamic than the gateway to your body – the mouth?” she continued. “It’s so ignored when you think about it, and it’s the most forward-facing part of your body that interfaces with the environment, and it’s connected to this entire tubing system. And yet we study everything but the mouth.”

The link between oral health and type 2 diabetes was first established in the 1990s, and Prof Kumar has led many investigations into this area. She was lead author in a study published last year that investigated the oral microbiomes of people with and without type 2 diabetes, and the effects of nonsurgical periodontitis treatment.

“Our studies have led up to the conclusion that people with diabetes have a different microbiome from people who are not diabetic,” Prof Kumar said. “We know that changing the bacteria in your mouth and restoring them back to what your body knows as healthy and friendly bacteria actually improves your glycemic control.”

The rough picture that has emerged is that oral bacteria are aerobic, but even small changes such as a few days of not brushing teeth can trigger a cascade that results in the bacteria shifting to an anaerobic, fermentative state producing toxins and byproducts. It becomes, as Prof Kumar puts it, “a septic tank” that stimulates the immune system and causes an inflammatory state, producing signalling products that bacteria then feed on.

“Then this community – it’s an ecosystem – shifts. Organisms that can break down protein start growing more, and organisms that can breathe in an oxygen-starved environment grow. The bacterial profile and, more importantly, the function of the immune system changes,” she explained.

The inflammation causes pores to open in the lining of the mouth, allowing the bacteria entry to the body.

“The body is producing inflammation in response to these bacteria, and those inflammatory products are also moving to the bloodstream, so now you’re getting hammered twice. Your body is trying to protect you and turning against itself,” Prof Kumar said. “And these pathogens are having a field day, crossing boundaries they were never supposed to cross.”

Though the relationship between oral health and certain disease is a complex one, Prof Kumar said prevention was exceedingly simple. Daily brushing and flossing with twice-yearly dentist visits for cleaning were sufficient.

Source: News-Medical.Net

Journal information: Kumar, P. S., et al. (2020) Subgingival Host-Microbial Interactions in Hyperglycemic Individuals. Journal of Dental Research. doi.org/10.1177/0022034520906842. 

Children with Sepsis Respond Better to ‘Relaxed’ Care Bundle

Following a ‘relaxed care bundle’ was linked to lower 30-day mortality and shorter hospital stays among children with sepsis, according to preliminary data from the Improving Pediatric Sepsis Outcomes (IPSO) FACTO trial.

The study findings were presented virtually at the Society of Critical Care Medicine’s Critical Care Congress.

Sepsis is the leading cause of death in children, with an estimated 7.5 million deaths a year. Childhood sepsis includes severe pneumonia, severe diarrhoea, severe malaria, and severe measles. Some 25-40% of children who recover from sepsis still have long-term consequences.

The ‘relaxed’ sepsis bundle is based on a group of best evidence-based interventions. It involves an initial fluid bolus delivery within 60 minutes, as opposed to 20 minutes; and antibiotic delivery within 180 instead of 60 minutes. Accepted sepsis recognition protocols (screen, huddle, or care order) were also involved with the bundle.

This trial data came from about 40 000 patients with sepsis or suspected sepsis at a range of children’s hospitals across the US, from 2017 to 2019. Raina M Paul, MD, of Advocate Children’s Hospital, Illinois, USA reported the data, saying that the relaxed bundle saw better outcomes than the more original bundle which was more time-restrictive. 
Sepsis-attributable mortality fell by 48.9% among the relaxed bolus-compliant versus non-compliant group (3.1% vs 3.5%), and by 13.7% in original bundle-compliant vs non-compliant cases. Following all aspects of the relaxed bundle was associated with a reduction in median days in hospital from 9 to 6 days.

In a separate presentation, Kayla Bronder Phelps, MD, of CS Mott Children’s Hospital in Michigan, USA, reported the results of a study that showed children hospitalised for severe sepsis were likely to have longer hospital stays if they were from lower-income neighbourhoods. Using a national database, she identified 10 130 cases of children with severe sepsis. Severe sepsis hospitalisations were also highest among the lowest-income quartile, reflecting the fact that there were more children living in low-income neighbourhoods.

Overall, 8.4% of children in the cohort died of sepsis during hospitalisation, with no association between mortality rates and income level. However, children in the lowest-income areas spent a median 9 days in the hospital, while children from the highest-income areas spent 8 days.

Bronder Phelps noted that the study is among the first to examine the impact of poverty on paediatric sepsis outcomes. Poverty is a known risk factor for a wide range of paediatric diseases, such as neonatal bacterial infection, asthma, and migraine, and in adults, poverty is associated with poorer outcomes including higher mortality rates.

Source: MedPage Today

Presentation information 1: Paul R, et al “Improving pediatric sepsis outcomes for all children together (IPSO FACTO): Interim results” SCCM 2021; Abstract 32.

Presentation information 2: Phelps K, et al “The association of socioeconomic status and pediatric sepsis outcomes” SCCM 2021; Abstract 37.

Nearly a Third of COVID Patients Are Readmitted to Hospital

According to a study reported by The Telegraph, almost a third of COVID patients are readmitted to hospital later. The new study, still on the MedRxiv preprint server and not yet peer reviewed, was conducted by Leicester University and the Office for National Statistics (ONS).

Approximately 1 in 10 people who are infected with COVID go on to develop long COVID symptoms, which include breathlessness, excessive fatigue and muscle aches. This appears to be causing hospital readmissions – and deaths.

The study looked at 47 780 individuals with a primary diagnosis of COVID who had a hospital visit between 1 January 2020 and 31 August 2020, and a COVID-negative control group admitted over the same period. The mean follow-up time was 140 days for those with a COVID diagnosis, and during this team 29.4% were readmitted and 12.3% died. The study also found a higher risk in those under 70 and of ethnic minority groups in the UK, most notably in respiratory diseases.

Study author Kamlesh Khunti, professor of primary care diabetes and vascular medicine at Leicester University, said: “This is the largest study of people discharged from hospital after being admitted with Covid.

“People seem to be going home, getting long-term effects, coming back in and dying. We see nearly 30 per cent have been readmitted, and that’s a lot of people. The numbers are so large.”The message here is we really need to prepare for long Covid. It’s a mammoth task to follow up with these patients and the NHS is really pushed at the moment, but some sort of monitoring needs to be arranged.”

One finding which surprised the team was that many patients went back in and had a new diagnosis, such as liver, heart or kidney conditions, as well as diabetes. This means, according to Prof Khunti, that it is important for patients to receive follow-up and protective therapies such as statins or aspirin, adding: “We don’t know if it’s because Covid destroyed the beta cells which make insulin and you get Type 1 diabetes, or whether it causes insulin resistance, and you develop Type 2, but we are seeing these surprising new diagnoses of diabetes.”

Source: Yahoo News