Tag: covid

Categories : COVID VaccinesTags :

Flu Shots May Offer Some COVID Protection

On By ModernMedia
Photo by Raghavendra V. Konkathi on Unsplash
Photo by Raghavendra V. Konkathi on Unsplash

The flu vaccine may provide a level of protection against COVID, a new study concludes.

An analysis of patient data from around the world strongly suggests that the annual flu shot reduces the risk of stroke, sepsis and DVT in patients with COVID. Flu-vaccinated COVID patients were also less likely to visit the emergency department and be admitted to the intensive care unit (ICU). The research was presented online at research being presented at the European Congress of Clinical Microbiology & Infectious Diseases (ECCMID).

Global COVID vaccination is a daunting challenge and, although production and distribution of vaccines increases daily, some countries are not expected to vaccinate large numbers of their population until the start of 2023.

Recently, several modestly-sized studies suggested that the flu vaccine may provide some measure of protection against COVID.

Ms Susan Taghioff, of the University of Miami Miller School of Medicine, and colleagues carried out a retrospective analysis of data on tens of thousands of patients from around the world to find out more.

In the largest study of its kind, the team screened de-identified electronic health records held on the TriNetX research database of more than 70 million patients to identify two groups of 37 377 patients, from countries including the US, UK, Germany, Italy, Israel and Singapore.

The two groups were matched for factors that could affect their risk of severe COVID-19, including age, gender, ethnicity, smoking and health problems such as diabetes, obesity and chronic obstructive pulmonary disease.

The first group had received the flu vaccine between two weeks and six months before COVID diagnoses. The second group also had COVID but were not vaccinated against flu. 

The incidence of 15 adverse outcomes, including sepsis and death, within 120 days of testing positive for COVID was then compared between the two groups. Analysis showed that those not vaccinated for flu were significantly more likely (up to 20%) to have been admitted to ICU.

They were also significantly more likely to visit the Emergency Department (up to 58%), to develop sepsis (up to 45%), to have a stroke (up to 58%) and a deep vein thrombosis (up to 40%). However, the risk of death was not reduced.

It isn’t known exactly how the flu jab provides protection against COVID but most theories centre around it boosting the innate immune system.

The results strongly suggest that the flu vaccine protects against several severe effects of COVID, according to the study authors. Further research is needed to prove this possible link but, in the future, the flu shot could be used to help bolster protection in countries short of COVID vaccine doses.

Senior author Dr Devinder Singh, professor of plastic surgery at the University of Miami Miller School of Medicine, said: “Only a small fraction of the world has been fully vaccinated against COVID to date and, with all the devastation that has occurred due to the pandemic, the global community still needs to find solutions to reduce morbidity and mortality.

“Having access to real-time data of millions of patients is a powerful research tool. Together with asking important questions it has allowed my team to observe an association between the flu vaccine and lower morbidity in COVID patients.

“This finding is particularly significant because the pandemic is straining resources in many parts of the world. Therefore, our research – if validated by prospective randomised clinical trials – has the potential to reduce the worldwide burden of disease.”

Ms Taghioff added: “Influenza vaccination may even benefit individuals hesitant to receive a COVID vaccine due to the newness of the technology.

“Despite this, the influenza vaccine is by no means a replacement for the COVID vaccine and we advocate for everyone to receive their COVID vaccine if able to.

“Continued promotion of the influenza vaccine also has the potential to help the global population avoid a possible ‘twindemic’ – a simultaneous outbreak of both influenza and coronavirus.

“Regardless of the degree of protection afforded by the influenza vaccine against adverse outcomes associated with COVID, simply being able to conserve global healthcare resources by keeping the number of influenza cases under control is reason enough to champion continued efforts to promote influenza vaccination.”

Source: EurekAlert!

Categories : COVIDTags :

Woman, 90, Succumbs to Double COVID Variant Infection

On By ModernMedia
Double COVID Variant Infection

Researchers in Belgium report on the case of a 90-year-old woman who was simultaneously infected with two different COVID variants.

On March 3 2021, the woman, with an unremarkable medical history, was admitted to a Belgian hospital after a spate of falls. She tested positive for COVID on the same day. She received nursing care at home, where she lived alone, and had not received a COVID vaccination.

At first, no signs of respiratory distress were seen, and oxygen saturation was good. However, she went on to develop rapidly worsening respiratory symptoms, and died five days later.

PCR testing revealed that she had been infected by two different strains of the virus — one which originated in the UK, known as B.1.1.7 (Alpha), and another that was first detected in South Africa (B.1.351; Beta).

“This is one of the first documented cases of co-infection with two SARS-CoV-2 variants of concern”, says lead author and molecular biologist Dr. Anne Vankeerberghen from the OLV Hospital in Aalst, Belgium. “Both these variants were circulating in Belgium at the time, so it is likely that the lady was co-infected with different viruses from two different people. Unfortunately, we don’t know how she became infected.”

The Alpha variant had been detected in the south east of England in December and within weeks, this variant displaced the viral strains circulating there. Since then, it has spread to more than 50 countries, including Belgium. The Beta variant was reported on December 18, 2020, and has since spread to 40 countries, which also includes Belgium.
Scientists in Brazil reported in January 2021 that two people had been simultaneously infected with two different strains of the coronavirus—the Brazilian variant known as B.1.1.28 (E484K) and a novel variant VUI-NP13L, which had previously been discovered in Rio Grande do Sul. However, this study has yet to be published in a scientific journal.

“Whether the co-infection of the two variants of concern played a role in the fast deterioration of the patient is difficult to say”, said Vankeerberghen. “Up to now, there have been no other published cases. However, the global occurrence of this phenomenon is probably underestimated due to limited testing for variants of concern and the lack of a simple way to identify co-infections with whole genome sequencing.”

She continued, “Since co-infections with variants of concern can only be detected by VOC-analysis of positive samples, we would encourage scientists to perform fast, easy and cheap VOC-analysis by PCR on a large proportion of their positive samples, rather than just whole genome sequencing on a small proportion. Independent of the technique used, being alert to co-infections remains crucial.”

Source: EurekAlert!

Categories : COVIDTags :

Emerging Variants Threaten a Worsening of the Pandemic

On By ModernMedia
Photo by Viktor Forgacs on Unsplash

Progress against the COVID pandemic has been impeded by the emergence of new variants of concern (VOC), and new ones may further worsen and prolong it.

VOCs increase the transmissibility of the SARS-CoV-2 virus and hence raise the reproduction number. Furthermore, they enhance the immune escape capabilities of the virus and blunt the effectiveness of available vaccines. Finally, they increase the pathogenicity of the infection.

Alpha, Beta, and Gamma VOCs with the N501Y mutation replaced the initial wild-type SARS-CoV-2 strains in Ontario, Canada, and then the Delta variant dominated during the period between February to June 2021. While enhanced virulence of VOCs having the N501Y mutation has been reported, there is a lack of comprehensive analyses that demonstrate increased virulence of the Delta variant.

Researchers from Toronto University, Canada, recently showed that these emerging VOCs were linked to increased virulence, as determined by hospitalisation risk, ICU admission, and mortality. This study is currently available on the medRxiv preprint server.

The researchers created a retrospective cohort of patients testing positive for SARS-CoV-2 in Ontario and screening for VOCs between February 3 and July 1, 2021. Case data was gathered from the Ontario provincial Case and Contact Management (CCM) database. All PCR positive COVID-19 specimens with a cycle threshold (Ct) ≤ 35 were screened for the N501Y mutation using the real-time PCR assay from the Public Health Ontario Laboratory. Whole genome sequencing (WGS) was performed on 5% of specimens regardless of the presence of mutations.

Results show that infection by VOCs with the N501Y mutation significantly elevated risk of hospitalization, ICU admission, and death in patients in Ontario.

Compared to non-VOC strains of SARS-CoV-2, the increase in risk associated with N501Y-positive variants was 138% (105-176%) for ICU admission; 74% (62-86%) for hospitalisation; and 83% (57-114%) for death, after adjusting for age, sex, and comorbidity. Increase in risks associated with the delta variant was even higher- 241% (163-344%) for ICU admission; 105% (80-133%) for hospitalisation; and 121% (57-211%) for death.

VOCs with the N501Y mutation were found to be associated with a significantly higher risk of hospitalisation, ICU admission, and death in infected individuals in Ontario, Canada. They also reveal that the Delta variant, becoming dominant in Ontario, has increased these risks even further.

“Individuals infected with VOCs were, on average, younger and less likely to have comorbid conditions than those infected with non-VOC, but nonetheless had higher crude risks of hospitalisation and ICU admission,” the authors found.

According to the authors, the clear and significant elevation of risks of even delayed outcomes such as death visible in their analysis is remarkable given the relatively small number of delta variant infections in the time period of this study. The fact that Canada is one of the leading countries in the world in terms of COVID vaccination rates has certainly mitigated the impact of these VOCs.

In summary, the researchers showed that despite excellent vaccination rates in Ontario, Canada, and VOCs infecting predominantly younger and healthier individuals, these VOCs are associated with an increase in virulence and risk of death. In particular, the Delta variant is more virulent compared to previously dominant VOCs possessing the N501Y mutation. It is the authors’ view that the progressive increase in transmissibility, immune escape and virulence of emerging VOCs could result in the pandemic being more drawn out and deadly.

Source: News-Medical.Net

Categories : COVID ExerciseTags :

Lower COVID Risk in Men Physically Fit When Young

On By ModernMedia

Many Swedish men who were physically fit when they did their military service were able to avoid being hospitalised when they became infected with COVID up to 50 years later. 

The results of the study by University of Gothenburg researchers are now available in the BMJ Open.

Sweden has a system of military conscription for its citizens, which it reinstated in 2017 and expanded to include women. The study drew on the Swedish Conscription Register, which contains data on over 1.5 million young Swedish men who began their military service in the years 1969–2005. Nearly all of these men then underwent both a bicycle test and a strength test. In spring 2020, some 2500 of the men included in the Conscription Register were hospitalised with COVID.

The men were divided into three groups based on their results in the fitness and strength tests, and their data were merged with three other Swedish registers: the National Inpatient Register (IPR, also known as the Hospital Discharge Register), Intensive Care Register, and Cause of Death Register. Analysis showed a clear link between fitness and strength in youth and the risk COVID hospitalisation 15–50 years after conscription.

Lead author Agnes af Geijerstam, PhD Student, University of Gothenburg’s Sahlgrenska Academy said, “At the population level, we can see that both good fitness and good muscle strength in the late teens are protective factors for severe COVID. For those with good fitness at the time of conscription, the risk of dying in spring 2020 was half as high as for the least fit. For those whose strength was good back then, too, we see a similar protective effect.”

However, since the oldest men in the study had not reached age 70, COVID deaths were uncommon in the study.

“Previous studies have shown that obesity is a risk factor for severe COVID. But we see that good fitness and strength are protective factors for everyone, including men with overweight or obesity,” said Professor Lauren Lissner, senior coauthor of the study.

Moreover, the study showed a link between the men’s height to the risk of COVID-19 infection.

“The taller the men were, the greater their risk of needing advanced care when they had gotten COVID; but per centimeter this increase in risk is very small. Also, unlike fitness and strength, there is no way to influence our height” af Geijerstam says.

Many studies have already demonstrated the protective effect of good physical fitness in numerous medical conditions, including infections. It has been established that physical activity strengthens the immune system and reduces inflammation propensity. Fitness during adolescence is also likely to be associated with active and otherwise healthy lifestyles throughout adult life.

“It’s interesting to see that the high fitness and strength levels those men had so many years ago can be linked to protection against severe COVID. Today, young people are becoming ever more sedentary, and that means there’s a risk of major problems arising in the long term — including a reduced resistance to future viral pandemics. Children and adolescents must get ample scope to move around,” af Geijerstam said.

Source: University of Gothenburg

Journal information: af Geijerstam, A., et al. (2021) Fitness, strength and severity of COVID-19: a prospective register study of 1 559 187 Swedish conscripts. BMJ Open. doi.org/10.1136/bmjopen-2021-051316.

Categories : COVID HospitalsTags :

As Gauteng Weathers Third Wave, Western Cape Readies its Defences

On By ModernMedia
Image by Quicknews

While COVID infection rates in Gauteng remain high, Western Cape is now firmly in a third wave, with an average of 1969 new cases a day. The healthcare system there has been monitoring the situation and preparing for the expected surge in cases.

“We are in a steep third wave, driven by the Delta variant and urge everyone to adhere strictly to protective behaviours, as a key drive to contain it. We anticipate that the third wave could be as high as the second wave. We await revised modelling from the SACMC to re-calibrate our response,” said head of health Dr Keith Cloete. Data on cases, healthcare capacity and details of the Western Cape’s responses were made available on the SA Coronavirus Portal.

In the Western Cape, the reproductive number has been over one for the past two months and is currently sitting at approximately 1.2, meaning an acceleration of new cases. The test positivity rate is at about 32%.

The public and private sector are using around two-thirds of the oxygen production capacity of Afrox’s plant. The level 4 restrictions with their accompanying alcohol ban saw a significant drop in week-on-week trauma presentations (~25%) and weekend trauma burden (~33% drop). This comes even with the context typical end of month increase as well as expected remaining alcohol stock, demonstrating the ban’s effectiveness.

The modelling referred to by Dr Cloete currently shows a high of ~500 daily admissions by 17 July, however an updated model is awaited. Public sector COVID bed capacity is being increased by converting beds and opening field hospitals, with a planned capacity of 2300 beds.

About 48.5% and 10.4% of the Western Cape population aged 60+ and 50-59 respectively have been vaccinated so far. Meanwhile, in a media briefing on Friday, Acting Health Minister Mmamoloko Kubayi-Ngubane announced that COVID vaccine registration for South Africans between the ages of 35-49 will open on July 15, with vaccinations for this age group planned to commence on August 1.

Categories : COVID Ethics and LawTags :

Why the ‘Lab Leak’ Scenario Was Shouted Down

On By ModernMedia
SARS-CoV-2 virus. Source: Fusion Medical Animation on Unsplash

For most of 2020, the notion that SARS-CoV-2 may have originated in a lab in Wuhan, China, was regarded as a debunked conspiracy theory, only embraced by some conservative media supportive of President Donald Trump. But in early 2021 that all changed, and today most outlets across the political spectrum agree that the ‘lab leak’ scenario deserves serious investigation.

An investigation by The BMJ uncovered a concerted campaign by researchers with funding on pandemic-potential virus research to label ‘lab leak’ scenarios as a conspiracy, effectively stifling journalism and investigation into the topic for over a year. One of the leaders of this was Peter Daszak, president of EcoHealth Alliance, a non-profit organisation which received millions in grants for pandemic preparedness research. EcoHealth Alliance subsequently subcontracted work out to the Wuhan laboratories.

Almost from the outset of the pandemic, a February 2020 statement in the Lancet coauthored by Daszak effectively ended the debate. “We stand together to strongly condemn conspiracy theories suggesting that covid-19 does not have a natural origin.” 

“It’s become a label you pin on something you don’t agree with,” said Nicholas Wade, a science writer who has worked at Nature, Science, and the New York Times. “It’s ridiculous, because the lab escape scenario invokes an accident, which is the opposite of a conspiracy.” 

But hostility to the scenario continued to grow. Filippa Lentzos, codirector of the Centre for Science and Security Studies at King’s College, London, told the Wall Street Journal, “Some of the scientists in this area very quickly closed ranks.” She added, “There were people that did not talk about this, because they feared for their careers. They feared for their grants.”

Daszak wrote an essay for the Guardian in June 2020 attacking the former head of MI6 for saying that the pandemic could have “started as an accident,” and continued to receive support from coauthors of the letter. 
But Daszak’s role in drawing up the statement in the Lancet was revealed in November 2020 in emails obtained through freedom of information requests.

“Please note that this statement will not have EcoHealth Alliance logo on it and will not be identifiable as coming from any one organization or person,” wrote Daszak in a February email, while sending around a draft of the statement for signatories. He also considered omitting his name from the statement to reduce potential negative exposure. A number of the 27 co-signatories omitted reporting their ties to EcoHealth Alliance.

Richard Ebright, professor of molecular biology at Rutgers University in New Jersey and a biosafety expert, considered scientific journal to be complicit in helping to clamp down on talk of a lab leak. “That means Nature, Science, and the Lancet,” he said. Along with dozens of other academics, he has been pushing back against the conspiracy theory labelling of the lab leak scenario.

“It’s very clear at this time that the term ‘conspiracy theory’ is a useful term for defaming an idea you disagree with,” said Ebright, referring to journalists and scientists making use of the term to attack others. “They have been successful until recently in selling that narrative to many in the media.”

Daszak enjoyed more support after then-President Trump cancelled EcoHealth Alliance’s National Institutes of Health funding, and the lab leak scenario remained buried for most of the year. It only resurfaced when a January 2021 New York magazine published an article detailing a possible lab leak scenario, in the face of stiff criticism. The tide began to turn when the World Health Organization investigation (which included Daszak) produced a report which attracted criticism for effectively ruling out the lab leak scenario in the face of almost a complete lack of evidence, such only being allowed a few hours’ worth of supervised access to the Wuhan labs. When Donald Trump lost the Presidential office, the criticism suddenly lost its greatest means for shutting down challenges — its mere association with its most widely-known and disliked proponent. 

Citing an intelligence report, the Wall Street Journal, recently reported that three Wuhan Institute of Virology researchers were admitted to hospital in November 2019. When President Joe Biden ordered an investigation into the scenario, it marked a slow turn-around in media coverage. Many outlets started backtracking their previously publicised viewpoints or adding qualifying statements, justifying them as simply a matter of tracking a “scientific consensus” which, they say, has now changed. Vox posted an erratum noting, “Since this piece was originally published in March 2020, scientific consensus has shifted.”

In recent weeks, a number of high profile scientists who once denigrated the idea that the virus could have come from a lab have made small steps into demanding an open investigation of the pandemic’s origin.

In a recent interview, NIH director Francis Collins said, “The Chinese government should be on notice that we have to have answers to questions that have not been answered about those people who got sick in November who worked in the lab and about those lab notebooks that have not been examined.” He added, “If they really want to be exonerated from this claim of culpability, then they have got to be transparent.”

It is worth noting that searches with phrases like “conspiracy theory”, “lab leak” and “Wuhan” do not turn up any relevant hits on The BMJ website, other than articles published this year which discuss the lab leak scenario seriously and credibly, or an article which discusses the more outlandish viral disinformation typical of the COVID pandemic typically seen in social media. Nor are there any articles with “Daszak” as an author.

Source: The BMJ

Categories : COVID GenderTags :

A Possible Explanation for Greater COVID Severity in Males

On By ModernMedia
SARS-CoV-2 viruses (yellow) on an infected cell. Source: NIAID

Researchers studying COVID patients have uncovered a metabolic pathway linked to immune responses only in male patients, a group known to be more likely to suffer severe cases and die of the disease.

Male COVID patients were more likely than female patients or healthy control subjects to have elevated levels of kynurenic acid, a product of amino acid metabolism, according to the study. High levels of kynurenic acid have been linked to several diseases, such as schizophrenia and HIV-related diseases.

They found that male patients with severe COVID cases were also more likely to have a high ratio of kynurenic acid to kynurenine, a byproduct of the amino acid L-tryptophan which is used to create the nutrient niacin.

“We know that men are at higher risk than women of contracting severe cases of COVID and that sex differences in the body’s immune responses present a compelling explanation for this phenomenon,” said Caroline Johnson, an assistant professor of epidemiology at Yale School of Public Health and senior author of the study. “We also know that immune responses are regulated in part by metabolites, and so these new findings offer a key window into the mechanisms underlying how this disease affects female and male patients differently.”

The team studied blood samples drawn from 22 female and 17 male patients at Yale New Haven Hospital after confirmation of COVID infection. They then compared these samples with samples from 20 uninfected health care workers.

The researchers positively identified 75 metabolites, which are molecular products of digestion and cellular processes. After adjusting for  age, body-mass index, sex, and other factors, the researchers identified 17 metabolites that were associated with COVID infection. Further analysis showed the strong relationship between high levels of kynurenic acid as well as high ratios of kynurenic acid to kynurenine in the male immune response and worse patient outcomes.

“Such sex-specific pathways provide major clues about how this disease infects and sickens individuals,” Prof Johnson said. “We can use this knowledge to create more effective treatments for this terrible disease and similar diseases.”

Source: Yale University

Categories : COVID General InterestTags :

Month-long COVID Coma Left Ambulance Worker ‘Scarred’

On By ModernMedia
Photo by Ian Taylor on Unsplash

A UK ambulance worker who contracted COVID and was in an induced coma for over a month says his family is psychologically scarred by what happened.

Paul Clements, 59, had major organ failure as well as several infections, leaving him in intensive care at Bristol Royal Infirmary. Doctors told him he was lucky to survive the 33-day induced coma. Speaking to the BBC, Mr Clements said that the time passed “in the blink of an eye”.

“The last thing I remember is being handed a cup of tea by my daughter,” said Mr Clements. He was agitated, complaining that the tea tasted awful, prompting concern from his family.

“I put it down, and then I blinked. I then found myself lying on a bed looking at a nurse,” he recalled. “I told her that I’d put my tea down somewhere.”

He said the nurse laughed in response, and then explained to him that he “had been unconscious for 33 days.”

On 19 March 2020, Mr Celements began to have COVID symptoms. Five days later, he was rushed into hospital.

“They tried three times to wake me up. The doctors told me I had pneumonia, a chest infection, an abdominal infection, kidney failure and liver failure – all wrapped up in COVID.” Up to a third of hospitalised COVID patients in the UK’s first wave had ‘do not resuscitate’ orders, recorded on or just before their admission.

He says that “Trying to get my head around that was almost impossible. Even now they have no idea why I survived.”

At the time, his family weren’t allowed to visit the Bristol Royal Infirmary where he was due to COVID restrictions.

“It was hell, absolute hell,” said Paul’s wife, Kerri. “Every time the phone rings you’re on edge thinking this is a call we don’t want. Listening out for his breathing every night, if he coughs I’m on edge, if he says he doesn’t feel well we’re back on edge.”

Mr Clements spent a total of three months in hospital before being leaving the ward to applause by the staff.

He returned to his work as an emergency care assistant six months later, with South Western Ambulance Service where has been for the past 38 years. He acknowledges the close call he had. “Unfortunately in my job I’ve put people in body bags and taken them to the mortuary,” he said.

“I spent some time in hospital trying to get my head around it and realised that could’ve been me, and the reality of it is so scary.”

Source: BBC News

Categories : COVIDTags :

Male and High BMI not Linked to COVID ICU Mortality

On By ModernMedia
Photo by Mufid Majnun on Unsplash

A new meta-analysis shows that, contrary to some previous research, being male and increasing body mass index (BMI) are not associated with increased mortality in COVID patients in intensive care units (ICU).

However, the study by Dr Bruce Biccard (Groote Schuur Hospital and University of Cape Town) and colleagues found that there were a wide range of factors linked to death from COVID in ICU. An August 2020 study of ICU COVID patients in Europe showed an association for age but not male sex.

The meta-analysis, which includes 58 studies and 44 305 patients published in the journal Anaesthesia, showed that, compared to patients without these risk factors, ICU COVID patients had a 40% greater mortality risk with smoking history, 54% higher with hypertension, 41% higher with diabetes, 75% higher with respiratory disease, around twice as high with cardiovascular disease or cancer, and 2.4 times higher with kidney disease. Other factors associated with an increased risk of death were the severity of organ failure, needing mechanical ventilation (a factor of 2.5 over non-ICU), as well as increased white blood cell counts and other inflammation markers.

The authors believe that age may effectively represent frailty in COVID patients which impacts on a person’s physiological reserve to overcome a critical illness. Hypertension, smoking and respiratory disease may be linked by their association with angiotensin-converting enzyme (ACE) receptors in the body, since there is increased expression of ACE-2 receptors amongst smokers and patients with chronic obstructive pulmonary disease. The link between hypertension and cardiovascular disease and increased mortality may be associated with the risk of cardiac injury which occurs with the systemic inflammatory response to COVID infection.

The authors said: “The findings confirm the association between diabetes, cardiovascular and respiratory comorbidities with mortality in COVID patients. However, the reported associations between male sex and increasing BMI worsening outcomes are not supported by this meta-analysis of patients admitted to ICU. This meta-analysis provides a large sample size with respect to these risk factors and is a robust estimate of risk associated with male sex and BMI.”

Source: EurekAlert!

Journal information: Anaesthesia, doi.org/10.1111/anae.15532

Categories : COVID Injury & TraumaTags :

Trauma Patients with COVID at Great Risk

On By ModernMedia
Photo by Nate Isaac on Unsplash

The COVID pandemic has placed a great strain on healthcare resources, with a number of indirect impacts ranging from increased incidence of heart attacks to decreased cancer screenings, but also increased the risk of complications and death among trauma patients with COVID. 

The study revealed that the risk of death for COVID-positive patients in trauma centres across the US state of Pennsylvania was six times higher than non-COVID-negative patients with similar injuries. Complication risk in COVID-positive patients was doubled for venous thromboembolism, renal failure, need for intubation, and unplanned ICU admission, and was five times greater for pulmonary complications. In patients over age 65, the risks were even higher. The findings were recently published in The Journal of Trauma and Acute Surgery.  

“COVID had the largest impact on patients whose injuries were relatively minor, and who we would have otherwise expected to do well,” said lead author Elinore Kaufman, MD, MSHP, an assistant professor in the Division of Trauma, Surgical Critical Care and Emergency Surgery at Penn Medicine. “Our findings underscore how important it is for hospitals to consistently test admitted patients, so that providers can be aware of this additional risk and treat patients with extra care and vigilance.”

Researchers conducted a retrospective study of 15 550 patients admitted to Pennsylvania trauma centers from March 21, 2020, (when non-essential businesses statewide were ordered close) to July 31, 2020. Of the 15 550 patients, 8170 were tested for the virus, and 219 tested positive. During this period, the researchers evaluated length of stay, complications, and overall outcomes for patients who tested positive for COVID, compared to patients who did not have the virus. They found that rates of testing increased over time, from 34% in April 2020 to 56% in July. Centres had a great variability in testing, a median of 56.2% of the time with a range of 0 to 96.4%.

“First, we need to investigate how to best care for these high-risk patients, and establish standard protocols to minimise risks,” said senior author Niels D Martin, MD, chief of Surgical Critical Care and an associate professor in the division of Trauma, Surgical Critical Care and Emergency Surgery. “Second, we need more data on the risks associated with patients who present symptoms of COVID, versus those who are asymptomatic, so we can administer proven treatments appropriately and increase the likelihood of survival with minimal complications.”

Source: University of Pennsylvania