Tag: covid

Younger COVID Survivors More Likely to Recover Sense of Smell

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For 4 out of every 5 COVID survivors, those who have lost sense of smell or taste have these return within six months, with those under 40 more likely to recover, according to a new study.

Among 798 respondents to an ongoing survey of people who had COVID and reported a loss of smell or taste, participants who were younger than 40 recovered their sense of smell at a higher rate than those older than 40, according to study results published in the American Journal of Otolaryngology last month.

Evan Reiter, MD, medical director of the Smell and Taste Disorders Center at Virginia Commonwealth University Health and a co-investigator on the study, said the latest data show 4 in 5 participants, regardless of age, regained their smell and taste within six months.

Insights into COVID survivors’ recovery came from symptoms experienced and pre-existing conditions they had. Those with a history of head injury were less likely to recover their sense of smell, as well as those who had shortness of breath during COVID. However, those with nasal congestion had a higher likelihood of smell recovery.

There have been more than 230 million cases of COVID worldwide, according to the World Health Organization. If estimates from the survey reflect populations worldwide, more than 20 million people could have lingering loss of smell or taste more than six months after COVID.

Previous survey results published in April showed 43% of participants reported feeling depressed and 56% reported decreased enjoyment of life in general while experiencing loss of smell or taste. The most common quality-of-life concern was reduced enjoyment of food, with 87% of respondents indicating it was an issue. An inability to smell smoke was the most common safety risk, reported by 45% of those surveyed. Loss of appetite (55%) and unintentional weight loss (37%) continue to pose challenges for patients, Prof said Professor Daniel Coelho, lead author of the study.

Smell training using essential oils could help people trying to recover their sense of smell.

“I continue to recommend that to my patients. It’s low cost and low risk,” Dr Reiter said.

The Clinical Olfactory Working Group, an international group of physicians with a strong research interest in the sense of smell, recommended the method as an option early this year. The group found that smell (olfactory) training could help foster recovery of nerve damage.

“I’d also say potentially it may get people a little bit more tuned into whatever level of function they have left so it might make them more sensitive and better able to use the remaining sensors and neurons that are working,” Dr Reiter said.

Meanwhile, researchers are in the early stages of developing an implant device to restore sense of smell, which began years before the pandemic. The device would behave much like a cochlear implant, which restores hearing for those with hearing loss.

Source: Virginia Commonwealth University

1 in 7 Cancer Patients Missed Surgery Due to Lockdowns

Source: Pixabay CC0

One in seven cancer patients around the world have missed out on potentially life-saving operations during COVID lockdowns, according to a new study led by the University of Birmingham.

Planned cancer surgery was impacted by lockdowns regardless of the local COVID rates at that time, especially in lower income countries.
Though lockdowns have protected the public from COVID, they have had collateral impact on care for other patients and health conditions. Researchers in this study showed that lockdowns resulted in significant delays for cancer surgery and potentially more cancer deaths.

Researchers are calling for major global reorganisation during the pandemic recovery to provide protected elective surgical pathways and critical care beds that will allow surgery to continue safely, as well as investment in ‘surge’ capacity for future public health emergencies.

‘Ring-fenced’ intensive care beds would support patients with other health conditions and those with advanced disease (who are most at risk from delays) to undergo timely surgery. Investment in staffing and infrastructure for emergency care would mitigate against disruption of elective services.

The COVIDSurg Collaborative involved 5000 surgeons and anaesthetists around the world working together as part of the to analyse data from the 15 most common solid cancer types in 20 000 patients in 61 countries. The findings were reported in The Lancet Oncology.

The researchers compared cancellations and delays before cancer surgery during lockdowns to those during times with light restrictions. During full lockdowns, one in seven patients (15%) did not receive their planned operation after a median of 5.3 months from diagnosis – all with a COVID related reason for non-operation. However, during light restriction periods, the non-operation rate was very low (0.6%).

Patients awaiting surgery for longer than six weeks during full lockdown were less likely to have their planned cancer surgery. Frail patients, those with advanced cancer, and those waiting surgery in lower-middle income countries were all less likely to have the cancer operation they urgently needed.

Researchers analysed data from adult patients suffering from cancer types including colorectal, oesophageal, gastric, head and neck, thoracic, liver, pancreatic, prostate, bladder, renal, gynaecological, breast, soft-tissue sarcoma, bony sarcoma, and intracranial malignancies.

Lockdowns directly impact hospital procedures and planning, as health systems change to reflect stringent government policies restricting movement. The researchers found that full and moderate lockdowns independently raised the likelihood of non-operation after adjustment for local COVID case notification rates. They hope that this information will help guide future lockdowns and restrictions by governments.

Source: University of Birmingham

New Mask Recycling Technology Could Cut Down on Waste

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Researchers have developed a way to quickly disinfect and electrostatically recharge used N95 respirators, restoring their effectiveness against COVID and other airborne diseases.

In their study published in Environment Science & Technology, the University of South Florida (USF) team showed their sterilisation technology could restore an N95 respirator’s original filtration efficiency of about 95 percent, even after 15 cycles of treatment. The technology fights coronavirus by using corona discharge, an electrical technique which simultaneously deactivating pathogens on a mask and restoring its electrostatic charges. It doesn’t require heat, or chemicals or contact, making it safe and convenient to use. It is safer than ultraviolet (UV) radiation and uses little electricity.

As well as restoring protection, the corona discharge treatment can reduce the impact of used masks on the environment. In a report by OceansAsia, a marine conservation organisation, 1.56 billion face masks polluted the oceans in 2020 and will likely take more than 450 years to fully decompose. The researchers say the technology will limit mask consumption to dozens each year instead of hundreds.

“It is a reduction of 90 percent for each user. If we assume that 10 percent of the population all over the world takes advantage of corona discharge mask reuse technology, there will be four- five billion fewer masks disposed to the environment,” said project lead Ying Zhong, assistant professor in the USF Department of Mechanical Engineering. “It will reduce at least 24 million tons of plastic pollution and reduce the amount of chemicals used for mask disinfection and avoid their environmental impact.”

“Despite the challenging conditions of the pandemic, this was the most thrilling project that I have ever worked on. We wish our research advances the understanding of how corona discharge disinfection can be turned into products on the market as soon as possible,” said co-project lead Libin Ye, assistant professor in the USF Department of Cell Biology, Molecular Biology and Microbiology.

The researchers are now working to develop this technology into products for hospitals and use by the general public, including handheld sterilisation devices.

Source: EurekAlert!

Is There a Wave of Teenage Lockdown Pregnancies in SA?

Image by Quicknews

An article in The Outlier examines whether the spike in teenage pregnancies in Gauteng could signal a tsunami of teenage pregnancies caused by the lockdown and increased sexual assaults.

In August the Gauteng MEC for health, Nomathemba Mokgethi, revealed that 23 226 teenage girls had fallen pregnant in the province between April 2020 and March 2021. This came in a written response to questions from the DA tabled in the Gauteng legislature. Alarmingly, 934 of them were between the ages of 10 and 14, where the age of consent is 16.

There were 20 250 babies born to teenage mothers aged 10 to 19, according to the Gauteng MEC in a response to a question in the Gauteng Legislature; 2976 pregnancies were terminated. From the start of the year to August, 118 babies were abandoned in public hospitals, some of them likely by teenage mothers.

A preliminary understanding of the impact of the pandemic on teen pregnancies can be seen through data from the annual District Health Barometer (DHB) report, which shows the number of deliveries recorded in public health facilities.

An increase in teenage births of 28% when comparing births to teenage mothers in Gauteng reported in the DBH for 2019/2020 with the Gauteng health department’s number, 
The Gauteng health department also provided a monthly breakdown of the teenage deliveries from April 2020 to March 2021. The months with the highest number of deliveries were May, June, July and August: most of these teenage mothers would have fallen pregnant before COVID hit South Africa.

In the early stages of the COVID pandemic, schools were closed on 18 March 2020, with the hard lockdown starting on 26 March, meaning that pregnancies from that time would be delivered around December 2020, which would likely not be reflected in the DBH for 2019/2020.

Catherine Mathews, director in the Health Systems Research Unit of the South African Medical Research Council (SAMRC) said it would take time to assess the full impact school closures had on teen pregnancies.  

“We do know that schools can be an important, safe, protective environment for girls, and when schools close, children are often left unsupervised and can be more at risk of sexual violence.”

Contraception has not been readily available to girls and women, with the District Health Barometer 2019/20 noting persistent stock-outs of contraception have been reported since 2018.

The SAMRC surveyed adolescent girls, aged 15 to 24, between 1 December 2020 and 28 February 2021, to find out how they were affected by the pandemic. The Outlier looked at the results for the 15 to 19 age group. Out of the 264 participants in this age group, 23.5% stated that they were unable to obtain contraceptives, while 18.8% reported challenges in accessing condoms due to the pandemic.

But, to connect the increase in teen pregnancies to the inaccessibility of condoms and contraception alone would be to assume that the 23 226 pregnancies were a product of consensual sex, when that may not always have been the case.

Mathews said: “Violence against women and girls in the country is so pervasive in South Africa and we can’t ignore its impact on teenage pregnancy.”

The MEC Mokgethi said, “Cases of statutory rape are reported by healthcare social workers at hospitals and clinics to the Department of Social Development and SAPS,” adding that no cases of statutory rape were collected by the health department.

Data for 2020/21 for the other eight provinces are not available, so it hasn’t been possible to see if this trend is reflected there,
However, the province with the highest percentage of teenagers of mothers giving birth is the Northern Cape at 18% in 2019/20. The Eastern Cape and KwaZulu-Natal follow with 16.7% and 16.4% respectively. Gauteng’s teenage birth rate was 7.5%, the lowest of the provinces.

According to World Bank data on births among women aged 15 to 19 years, South Africa’s 68 births per 1000 women was lower than other Sub-Saharan African countries, it remains higher than the world average of 42 births per 1000 women in that age group.

Source: The Outlier

Impact of Pandemic Delay to Cardiac Procedures

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A Canadian study found that after the onset of the COVID pandemic, there was a significant decline in referrals and procedures for common cardiac interventions. 

Patients awaiting coronary bypass surgery or stenting were at higher risk of dying while waiting for their procedure compared to before the pandemic, despite wait times not being longer. The study was published in the Canadian Journal of Cardiology.

“In the first wave of the COVID pandemic, we kept hearing stories from patients and other doctors that there were delays in care for patients with heart disease,” explained lead investigator Harindra C. Wijeysundera, MD, PhD, University of Toronto. “We decided to look into these claims using the Ontario database that keeps track of wait lists and wait times for individuals with heart disease who require a procedure or surgery.”

The researchers were able to link multiple population-based administrative data sources and clinical registries. The study looked at adult patients who were referred for four commonly performed cardiac procedures: percutaneous coronary intervention; isolated coronary bypass grafting; valve surgery; or transcatheter aortic valve implantation from January 1, 2014 to September 30, 2020, and the start of the pandemic was put at March 31 2020. Outcomes were defined as death while awaiting procedure and hospitalisation while waiting for procedure.

Of 584 341 patients identified, 37 718 were referred during the pandemic. As expected, a decline in referrals was observed at the outset of the pandemic, although those numbers steadily increased throughout the pandemic period, along with an initial decline in the number of procedures performed. Individuals waiting for coronary bypass surgery or stenting were at higher risk of dying while waiting for their procedure compared to before the pandemic. Mortality rates increased even though wait times did not during the pandemic, suggesting patients may have delayed in presenting to their doctors with symptoms.

“We found that the increase in wait list mortality was consistent across patients with stable coronary artery disease, acute coronary syndrome, or emergency referral,” said Dr Wijeysundera. “Coupled with reduced referrals, this raises concerns of a care deficit due to delays in diagnosis and wait list referral.”

A number of potential explanations were suggested by the researchers for the decline in referrals during the pandemic, from patient factors such as fear of contracting COVID in the hospital or concerns about missing work, to system factors including testing delays and pressures on hospital beds and staffing.

Source: EurekAlert!

More ACE2 Makes Pancreatic Cells a COVID Target

Source: CDC

Researchers have revealed insights into how SARS-CoV-2 attacks the insulin-producing cells of the pancreas.

There is mounting evidence of damage to the pancreas and resulting diabetes attributed to COVID, which is of great concern. The virus targets the angiotensin converting enzyme 2 (ACE2) protein on the surface of those cells, and is the subject of a special presentation at this year’s Annual Meeting of the European Association for the Study of Diabetes, given by the University of Siena’s Professor Francesco Dotta. 

“The SARS-CoV-2 virus attacks specific host tissues because of the presence of viral receptors on the surface of the target cells. As such, virus binding to ACE2 protein is the key determinant for its entry, propagation and transmissibility,” explained Prof Dotta.

“Multiple studies have shown that older adults and those with chronic medical conditions like heart and lung disease and/or diabetes are at the highest risk for complications from SARS-CoV-2 infections. Moreover, impaired blood sugar control is associated with increased risk of severe COVID, suggesting a link between COVID infection and diabetes. Several reports indicate a wide, although variable, distribution of the ACE2 protein among different tissues.”

Prof Dotta and colleagues studied the ACE2 expression pattern in pancreatic tissue samples of non-diabetic multiorgan donors to better understand the molecular link between COVID and diabetes.

In the ‘normal’ pancreas, ACE2 is highly expressed in microvasculature and in ductal cells. “Importantly, we found that ACE2 was expressed in human pancreatic islets, where it is preferentially expressed in insulin producing beta-cells. We also demonstrated that ACE2 levels were increased under pro-inflammatory conditions, thus confirming the link between inflammation and ACE2 also in pancreatic islet beta cells.”

In order to isolate the mechanism involved in the upregulation of ACE2 induced by inflammation, ACE2 levels were measured in human pancreatic islets pre-treated with Jak1/2 and TYK2 inhibitors, which block inflammation in beta cells, and then exposed to pro-inflammatory conditions. 

Prof Dotta said: “We showed that these drugs prevent the ACE2 increase induced by inflammation in human pancreatic islets, demonstrating that SARS-CoV-2 receptor ACE2 is regulated through specific molecular pathways and that its increased expression can be prevented.

“We studied the mechanisms of SARS-CoV-2 virus entry into insulin producing beta cells and we discovered that these cells express the SARS-CoV-2 receptor ACE2.” Other authors have independently confirmed such data.

Of note, additional published data confirmed that SARS-CoV-2 can indeed infect pancreatic insulin-producing cells causing their dysfunction or death. Moreover, during inflammation, ACE2 expression increases several times above standard values.

Prof Dotta concluded: “This means that these insulin-producing beta cells could be even more susceptible to viral infection when inflamed. This finding is also important from a clinical standpoint, since keeping inflammatory status under control in patients with COVID may reduce the expression of ACE2 receptor in beta cells with beneficial effects on blood sugar and metabolic control of patients.”

Source: EurekAlert!

Now Iodine is the In-thing for COVID

A dangerous new trend has emerged on social media, which involves a new COVID ‘cure’ by gargling the widely used antiseptic, povidone-iodine (PVP).

This trend has been sparked by an online video in Thai which has been widely shared on social media, featuring someone who claims to be a doctor. However this has been debunked. The trend is also cause for concern as the PVP may accidentally be swallowed. 

PVP, also sold under the name Betadine, is used for disinfection in surgical procedures and wound treatment. Gargling with 0.5% PVP has been shown to reduce the symptoms of sore throat associated with COVID, but has not been adequately shown to relieve any other symptoms.  
The immediate side effects of ingesting any PVP antiseptic include nausea, vomiting, general weakness, and diarrhoea. In severe cases, PVP ingestion can result in acute renal failure, cardiovascular collapse, liver function impairment, shortness of breath, low blood pressure, and even death.

In one study, researchers assessed the usage of 0.5% povidone-iodine mouthwash in patients as a way of reducing viral load during dental procedures, reducing possible exposure of healthcare workers. However, there is no evidence beyond in vitro testing that it actually reduces viral load in the throat. 

An official statement on the Betadine website reads as follows: “Betadine® Antiseptic First Aid products have not been approved to treat coronavirus. Products should only be used to help prevent infection in minor cuts, scrapes and burns. Betadine Antiseptic products have not been demonstrated to be effective for the treatment or prevention of COVID-19 or any other viruses.”

Source: Newsweek

AstraZeneca Vaccine Confers COVID Protection for People with HIV

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Interim results from a phase 1B/2A clinical trial conducted by the Wits Vaccines and Infectious Diseases Analytical (VIDA) research unit showed that the AstraZeneca vaccine conferred COVID protection in people living with HIV.

The findings, published in Lancet HIV, show that the AstraZeneca COIVD vaccine is likely to work as well in people living with HIV compared with people who are HIV negative.

These interim findings are vital for informing the clinical management of people with HIV during the COVID pandemic.

In general, clinical trials which evaluate the safety and immunogenicity of COVID vaccines in people living with HIV are limited, and in Africa they are virtually non-existent. This is despite the overwhelming prevalence of HIV infection in Africa, especially South Africa .

“We searched PubMed for peer-reviewed articles published between 1 January 2019 and 29 June 2021, using the terms ‘safety’ and ‘Covid-19’ and ‘vaccine’, but we did not find any reports that evaluated safety and immunogenicity of COVID vaccines in this population,” said Shabir Madhi, Professor of Vaccinology and Director of Wits VIDA, which led the first South African trial for a COVID vaccine in June 2020.

Compared to the general population, people living with HIV have an increased risk of infectious diseases and have a greater mortality risk when hospitalised with severe COVID.

In addition, compared with HIV-negative individuals, people with HIV are at greater risk for infectious diseases, such as influenza, including during antiretroviral therapy (ART).

Risk factors for severe COVID in people with HIV include more advanced stage of HIV/AIDS, the HIV-1 infection not being virally suppressed, and CD4 counts below 500 cells per microlitre.

The study was an interim analysis of a randomised, double-blind, placebo-controlled, phase 1B/2A trial. In 2020, the trial enrolled 104 people living with HIV were enrolled in the trial, HIV-negative people. Eligibility criteria for people with HIV included being on ART for at least three months, with a plasma HIV viral load of less than 1000 copies per microlitre.

The HIV study was a unique addition to the AstraZeneca COVID vaccine clinical trial, and aimed to assess safety and immunogenicity of this vaccine in people with HIV and HIV-negative people in South Africa. The primary endpoint in all participants regardless of HIV status was the safety, tolerability, and reactogenicity profile of the AstraZeneca COVID vaccine.

Reactogenicity refers to a subset of reactions that occur soon after vaccination, and are a physical manifestation of the inflammatory response to vaccination. Such symptoms include pain, redness, swelling or induration for injected vaccines, and systemic symptoms, such as fever, myalgia, headache, or rash. In clinical trials, information on expected signs and symptoms after vaccination is actively sought.

The interim findings show that the AstraZeneca COVID vaccine was well tolerated and showed favourable safety and immunogenicity in people with HIV, including heightened immunogenicity in SARS-CoV-2 baseline-seropositive participants.

Source: University of the Witwatersrand

Platelet Signalling Implicated in COVID Organ Damage

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New research finds that one cause of organ damage in COVID patients is abnormal crosstalk between blood platelets and cells lining blood vessels.

The study published in Science Advances, revealed the protein signals released by platelets cause inflammation, abnormal clotting, and damage to vessels when exposed to SARS-CoV-2.

The work identified two related genes, S1000A8 and S1000A9, which are turned up in the platelets of COVID patients, causing them to make more of myeloid-related proteins (MRP) 8 and 14. Higher levels of the dual proteins were linked in the study to higher levels of clotting and inflammation in vessels and worse outcomes.

In support of the theory that platelets are at the core of blood vessel damage in COVID, the research team also presented evidence that approved medications known to block platelet activation via the platelet surface protein P2Y12 (clopidogrel or ticagrelor) reduced COVID-related inflammation in vessels. The study also found that COVID-exposed platelets change cells lining blood vessels (endothelial cells) largely through a protein called p-selectin, which makes platelets stickier and more likely to form clots.

“Our findings reveal a new role for platelets in COVID blood vessel damage, and may explain in large part what makes the COVID virus so much more deadly than its relatives that cause the common cold,” said corresponding author Tessa Barrett, PhD,.

Abnormal, body-wide inflammation and blood clotting were identified early in the pandemic as central features of severe COVID-19, with the two thought to be interrelated, say the study authors. As blood components that react to injuries in vessels by triggering inflammation, and by becoming sticky to clump together in clots, platelets are a possible culprit. Increasing evidence shows that interplay between platelets and endothelial cells may be important to these disease mechanisms.

For the current study, endothelial cells from small blood vessels were exposed to fluid released from the platelets of either COVID patients or healthy controls. RNA was then sequenced, In the presence of COVID-activated platelets, changes were observed in the activity of the exposed endothelial cells. Genes expressed differently in COVID-19 were linked to clotting, inflammation, and the weakening of junctions between endothelial cells, which lets blood serum seep into tissue to cause the pulmonary oedema seen in severe cases, where patients’ lungs fill with fluid.

The large list was narrowed down to S100A8 and S100A9, which coded for the building of MRP 8 and 14. COVID in patients was found to increase the amount of MRP8/14 produced by platelets and other cells by 166 percent compared to controls. Higher levels of these proteins were linked to abnormal thrombosis, inflammation, and critical illness among hospitalised COVID patients. Curiously S100A8/A9 were not upregulated after exposure of platelets to a coronavirus relative, CoV-OC43, which causes the common cold.

Additionally, damage and abnormal clotting could arise from p-selectin, which promotes platelet clumping and immune-boosting signals. The researchers also found that the anti-clotting P2Y12 inhibitors reduced the expression of S100A8 and S100A9 in platelets by 18 percent over four weeks, and in lab tests prevented COVID platelets from inducing blood vessel damage.

“The current study supports the theory that platelets are activating endothelial cells through P-selectin, and that both p-selectin and MRP8/14 contribute to vessel damage and an increased risk of dying,” said senior study author Jeffrey S. Berger, MD. “As our team also leads ACTIV4a, a large, ongoing NIH-funded, anti-clotting trial in COVID, we are currently testing in patients whether P2Y12 inhibitors can better prevent severe disease, with the results to be presented at the American Heart Association annual meeting in November.”

Source: NYU Langone Health

Healthy Diets Reduce COVID Risk

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A study based on self-reported app data showed that people who eat a high quality, gut friendly diet are less likely to develop COVID-19 or become severely ill. Those eating poorer quality diets are more at risk, especially if they live in a more socioeconomically deprived area.

The study, presented in GUT, analysed data from almost 600 000 ZOE COVID Study app contributors. Participants completed a survey about the food they ate before the pandemic, in February 2020, making it the largest study in this space. 19% of these contributors contracted COVID-19.

People with the highest quality diet were around 10% less likely to develop COVID than those with the lowest quality diet, and 40% less likely to fall severely ill.

This is the first longitudinal study of diet and COVID and the first to show that a healthy diet cuts the chances of developing the disease in the first place.

Instead of looking at specific foods, the survey aimed to broadly capture people’s diets. A ‘diet quality score’ reflected the overall merit of each person’s diet. Diets with high quality scores were found to contain plant-based foods such as fruits, vegetables and whole grains, as well as oily fish, less processed foods and refined carbohydrates. A low diet quality score is associated with diets high in ultra processed foods and low amounts of plant based foods.

The researchers found that people who ate the highest quality diet were around 10% less likely to develop COVID-19 than those with the least nutritious diet and 40% less likely to become severely ill if they developed COVID.

The link between diet quality and COVID risk persisted after accounting for all potential confounding factors such as age and BMI. Mask-wearing habits and population density were also considered.

The effect of diet was amplified by individual life situations, with people living in low-income neighbourhoods with the lowest quality diet being around 25% more at risk from COVID than people in more affluent communities eating the same kind of diet.

Based on these results, the researchers estimate that nearly a quarter of COVID cases could have been prevented if these differences in diet quality and socioeconomic status had not existed. The study also showed that improved access to better food is an important public health consideration.

Dr Sarah Berry, study co-lead and Reader in nutritional sciences at the School of Life Course Sciences said: “For the first time we’ve been able to show that a healthier diet can cut the chances of developing COVID, especially for people living in the more deprived areas. Access to healthier food is important to everyone in society, but our findings tell us that helping those living in more deprived areas to eat more healthily could have the biggest public health benefits.”

Professor Tim Spector, professor of genetic epidemiology at the School of Life Course Sciences, said: “These findings chime with recent results from our landmark PREDICT study, showing that people who eat higher quality diets (with low levels of ultra-processed foods) have a healthier collection of microbes in their guts, which is linked to better health. You don’t have to go vegan, but getting more diverse plants on your plate is a great way to boost the health of your gut microbiome, improve your immunity and overall health, and potentially reduce your risk from COVID.”

Source: Kings College London