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To encourage young people to get vaccinated, the UK government has released a video in which young COVID patients tell their stories of battling the virus and suffering long-term debilitating effects.

The video features several patients who experienced serious symptoms of COVID or developed long COVID, as well as the doctors and frontline staff who treated them, to warn of the dangers of the virus for those who are not vaccinated. It is narrated by Dr Emeka Okorocha.

It comes as people aged 16 to 17 in England are offered a COVID vaccine, and all at-risk people aged 12 to 15 in England are also invited for a vaccination. Young people are being encouraged to take up the offer as soon as possible to build vital protection before returning to school in September.

A fifth of COVID hospital admissions in England are aged 18 to 34 – 4 times higher than the peak in the winter of 2020.

The patients who feature in the new short film have issued a rallying call: young people should take up the vaccine to avoid suffering a similar fate.

After putting off the vaccine, Quincy Dwamena, a 31-year-old videographer and support worker spent 2 weeks in hospital with COVID. He said: “I’m a healthy, young guy. I went to the gym often and have no underlying health concerns. I put off getting the vaccine because I thought the way I was living my life would mean there would be little to no chance of me catching the virus, or it would have little effect.

“But I ended up being hospitalised and thought I was going to die. My advice is to get the vaccine: don’t put yourself and others at risk, I wish I’d got mine as soon as it was offered.”

Ella Harwood, a 23-year-old illustrator from London, said:

I’m young and fit but I was bed-bound for 7 months with COVID-19. Before I caught the virus, I was super active and had no health concerns, but I now suffer with asthma which I didn’t have before and a number of allergies.

I fear I’ll never be the same again but I’m making progress and I’m very grateful that I’m still alive. Please get vaccinated if you haven’t already.

People aged 16 and 17 are able to get vaccinated at one of more than 800 GP-led local vaccination sites and NHS England has launched an online walk-in site finder to help this age group locate the nearest available centre. Further sites will come online over the coming days and weeks.

In the UK, 87.5% of people have received their first dose, and 76.3% have received their second. The interviews were filmed in London, where uptake among under 30s is lowest.

According to data from Public Health England, the highest COVID case rates are among 20 to 29-year-olds with a case rate of 670.7 cases per 100 000 people. Additionally, 6.3% of people aged 16 to 29 have had long COVID, higher than the national average. Many of these have said long COVID has had a major impact on their lives, especially the ability to exercise, work, and maintain relationships.

TV doctor and emergency medicine physician, Dr Emeka Okorocha said:

“As an A&E doctor, I’ve seen a lot during the pandemic. But nothing has shaken me like the sight of young, otherwise healthy adults, being rushed into our hospitals with COVID.

“As well as their age, many of them have 1 other thing in common, they are unvaccinated. Vaccines truly are the way out of this pandemic and are the best way to protect everyone from the virus, so please get your vaccine.”

Alongside Dr Emeka and patients, the film features interviews with the frontline workers who have been treating young COVID-19 patients.

Vaccines Minister Nadhim Zahawi said: “There is no doubt the COVID vaccination programme is having a major impact, keeping around 82 100 people out of hospital and saving an estimated 95 200 lives in England.

“But we are seeing more unvaccinated young people in hospital now than ever before. Please don’t delay – get your jabs to avoid a similar fate to these brave people who have shared their stories.”

Source: United Kingdom Government

A small study has found that the antibiotic azithromycin had no effect in prevention of COVID symptoms among non-hospitalised patients, and could increase hospitalisation risk, even though the antibiotic is widely used for the disease.

“These findings do not support the routine use of azithromycin for outpatient SARS-CoV-2 infection,” said lead author Catherine E Oldenburg, ScD, MPH, an assistant professor with the UCSF Proctor Foundation. 

Azithromycin, a broad-spectrum antibiotic of the macrolide class, is widely prescribed as a treatment for COVID-19 in the United States and the rest of the world. “The hypothesis is that it has anti-inflammatory properties that may help prevent progression if treated early in the disease,” said Oldenburg. “We did not find this to be the case.”

The study was published in the Journal of the American Medical Association.

The study recruited 263 non-hospitalised participants who had tested positive for SARS-CoV-2 seven days or sooner before entering the study. Of these, 171 participants were randomised to receive\ a single, 1.2 gram oral dose of azithromycin and 92 received an identical placebo.
At day 14, 50 percent of the participants remained symptom-free in both groups. By day 21, five of the participants who received azithromycin had been hospitalised with severe COVID symptoms and none of the placebo group had been hospitalised.

From these findings, the researchers concluded that treatment with a single dose of azithromycin compared to placebo did not result in greater likelihood of being symptom-free.

“Most of the trials done so far with azithromycin have focused on hospitalised patients with pretty severe disease,” said Oldenburg. “Our paper is one of the first placebo-controlled studies showing no role for azithromycin in outpatients.”

The PRINCIPLE study being conducted in the UK investigating common medications for community treatment of moderate COVID also found no benefit to using azithromycin.

Source: University of California, San Francisco

Journal information: Catherine E. Oldenburg et al, Effect of Oral Azithromycin vs Placebo on COVID-19 Symptoms in Outpatients With SARS-CoV-2 Infection, JAMA (2021). DOI: 10.1001/jama.2021.11517

A new study shows that being admitted to an intensive care unit (ICU) is linked to a small increased risk of future suicide or self-harm after discharge.

The findings show that survivors of critical illness who later died by suicide or had self-harm events had a tendency to be younger, with a history of psychiatric illness, and had received invasive life support. These results are particularly important in light of the large number of ICU survivors due to the COVID pandemic.  The study was published in The BMJ.

The researchers stressed that while the overall risk is still very low, knowledge of these factors “might allow for earlier intervention to potentially reduce this important public health problem.”

Survival after critical illness is associated with important effects, including muscle weakness, reduced exercise capacity, fatigue, cognitive impairment, pain, and financial hardship. Evidence is piling up that shows that ICU survivors have higher rates of psychiatric illness. Some 17–44% of ICU survivors have psychiatric symptoms. However it is yet not known whether that results in an elevated risk of suicide and self-harm.

Researchers in the Canada and the US therefore set out to analyse the association between survival from critical illness and suicide or self-harm after hospital discharge.

For their study, the researchers drew on health records for 423 000 adult ICU survivors in Ontario, Canada from 2009 to 2017.

They matched health records for 423 000 adult ICU survivors (average age 62 years, 39% women) with 3 million non-ICU hospital survivors with similar risk factors for suicide in Ontario, Canada from 2009 to 2017.

The researchers took into account possible confounding factors such as  age, sex, mental health history, and previous hospitalisation for self-harm.

Among ICU survivors, it was found that 0.2% of patients died by suicide compared with 0.1% of non-ICU hospital survivors.

Self-harm was seen in 1.3% of  ICU survivors compared with 0.8% of non-ICU hospital survivors.

ICU survivors were found to have a 22% higher risk of suicide compared with non-ICU hospital survivors risk of self-harm was 15% higher. The increased risk was greatest after discharge, and persisted in a reduced manner for several years afterward.

Younger ICU survivors (ages 18-34), were most likely to be at risk for suicide, along with those with pre-existing diagnoses of depression, anxiety or PTSD, and those who received invasive procedures such as mechanical ventilation or mechanical blood filtration due to kidney failure in the ICU.

This is a large study involving a cohort of consecutive ICU survivors from an entire population, with minimal missing data. However, given the observational design, the researchers cannot rule out the possibility that other unmeasured factors may have affected their results, and say these associations require further study.
Despite being a large cohort study from an entire population with little missing data, because it is an observational design the researchers cannot rule out the possibility of unknown factors affecting their results. However, the links do warrant further study.

“Survivors of critical illness have increased risk of suicide and self-harm, and these outcomes were associated with pre-existing psychiatric illness and receipt of invasive life support,” they wrote.

“Knowledge of these prognostic factors might allow for earlier intervention to potentially reduce this important public health problem,” the authors concluded.

Source: News-Medical.Net

Journal information: Fernando, S.M., et al. (2021) Suicide and self-harm in adult survivors of critical illness: population based cohort study. BMJ. doi.org/10.1136/bmj.n973.

In yet another discovery pointing to the benefits of physical activity, human muscle has been shown to stave off the destructive effects of chronic inflammation through exercise.

“Lots of processes are taking place throughout the human body during exercise, and it is difficult to tease apart which systems and cells are doing what inside an active person,” said Nenad Bursac, professor of biomedical engineering at Duke. “Our engineered muscle platform is modular, meaning we can mix and match various types of cells and tissue components if we want to. But in this case, we discovered that the muscle cells were capable of taking anti-inflammatory actions all on their own.”

Inflammation can be beneficial, such as a low-level response which clears out debris and helps regeneration, or it can be detrimental, such as the lethal COVID cytokine storms. Chronic inflammation as in arthritis or sarcopenia can be damaging as it takes away the ability of muscle to contract, resulting in weakening.

One inflammatory molecule in particular, interferon gamma, has been shown to be associated in many different types of muscular wasting. Interferon gamma is primarily produced by T lymphocytes and natural killer (NK) cells.

“We know that chronic inflammatory diseases induce muscle atrophy, but we wanted to see if the same thing would happen to our engineered human muscles grown in a Petri dish,” said Zhaowei Chen, a postdoctoral researcher in Bursac’s laboratory and first author of the paper. “Not only did we confirm that interferon gamma primarily works through a specific signaling pathway, we showed that exercising muscle cells can directly counter this pro-inflammatory signaling independent of the presence of other cell types or tissues.”

To determine if interferon gamma was the true culprit, Berac and Chen grew contractile human muscle tissue in vitro, then flooded it with interferon gamma over seven days. As predicted, the muscle shrank and lost strength,

They then applied interferon gamma again, but this time electrically stimulating the muscle to contract. They expected the simulated exercise to result in some muscle regrowth as seen in their previous studies, but to their surprise, the muscle suffered almost no effect from the chronic inflammation.They demonstrated that exercise blocked a particular molecular pathway as used in a pair of drugs to treat rheumatoid arthritis, tofacitinib and baricitinib, which produce the same anti-inflammatory effect.

“When exercising, the muscle cells themselves were directly opposing the pro-inflammatory signal induced by interferon gamma, which we did not expect to happen,” Bursac said. “These results show just how valuable lab-grown human muscles might be in discovering new mechanisms of disease and potential treatments. There are notions out there that optimal levels and regimes of exercise could fight chronic inflammation while not overstressing the cells. Maybe with our engineered muscle, we can help find out if such notions are true,” Bursac concluded.

Source: Medical Xpress

Journal information: Z. Chen el al., “Exercise mimetics and JAK inhibition attenuate IFN-γ-induced wasting in engineered human skeletal muscle,” Science Advances (2020). advances.sciencemag.org/lookup … .1126/sciadv.abd9502