COVID news & more, 5/18/24
We are starting to see an ever-so-slight increase in SARS-CoV-2 in wastewater in the western states. On a national level, wastewater viral activity for COVID is “MINIMAL” still. Hawaii has the highest level of SARS-2 in wastewater now, followed by Idaho. Here in the Bay Area, Santa Clara county reports “MEDIUM” levels of COVID in the wastewater of its four wastewater plants. In California, Sausalito, Santa Cruz, Laguna Niguel and San Rafael have COVID virus levels over 300 PMMoV. Biobot announced today that they will be sunsetting their dynamic COVID dashboard.
Hospitalizations and Emergency Department visits are no longer being reported nationally. KP.2 is now responsible for 28% of COVID cases and it is slowly squeezing out other competitor variants. According to JP Weiland, about 1 in every 192 people currently infected with COVID and he expects the number of cases to start to increase somewhat because of the FLiRT variants like KP.2.
Acute COVID infections, General COVID info
Reporter Katharine Lang reviewed some of COVID’s effects on the brain in an article in the BMJ. Neurologic symptoms after COVID infection can include fatigue, difficulty concentrating, and long-term cognitive defects. COVID infection can lead to a reduction in brain volume related to a reduction in neuron cell bodies and cytokines have been found to activate astrocytes in the brain causing neuroinflammation. Low peripheral serotonin reduces vagus nerve signaling to the hippocampus which can affect learning, memory, and emotion. COVID's effect on endothelial cells that line blood vessels can lead to microbleeds and strokes. The author suggested that COVID’s effect on the brain will lead to increased dementia as well. Two other articles this week support that SARS-CoV-2 infection can lead to Alzheimer’s disease and Parkinson’s disease.
An article in Lancet Neurology describes how SARS-CoV-2 infection can cause neurodegeneration. SARS-CoV-2 infection can cause vascular injury in the brain via infection of the endothelial cells that line blood vessels. COVID infections also increase the risk of blood clots which can lead to stroke. Even mild COVID infection can lead to neuroinflammation in the brain. In vitro, SARS-CoV-2 infection increases clumping of tau protein which is associated with Alzheimer’s disease. SARS-CoV-2 viral proteins also contain amyloidogenic regions, which could potentially lead to amyloid formation. The authors state that "SARS-CoV-2 infection should be considered as a risk factor for Alzheimer’s disease, even though the distinction between causation versus disease acceleration is not clear.“ They concluded, “In our opinion, antiviral therapy should be considered even for moderate SARS-CoV-2 infections to reduce the severity of symptoms and limit the likelihood of sequelae. Patients (especially children and those with post-acute sequelae [Long COVID]) should be supported and followed up.” I agree.
From: https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(24)00178-9/abstract
Another study this week shows that SARS-CoV-2 infection increases the risk of Parkinson’s disease in human embryonic stem cell (hESC)-derived dopaminergic (DA) neurons and in DA neurons in hACE2 Tg mice. In dopamine neurons, persistent neuroinflammation appears to be mediated by astrocytes and microglia.
There is an FDA approved test for traumatic brain injury (TBI) called the Banyan Brain Trauma Indicator (BTI) Assay that tests for blood levels of glial fibrillary acidic protein (GFAP, a marker of astroglial injury and neuroinflammation) and ubiquitin C-terminal hydrolase (UCHL1, a marker of neuron death). A group repurposed the BTI assay to check for brain injury in people with critical acute COVID infection. Generally, UCH-L1 and GFAP blood levels tend to increase with age. “Controlling for age, UCH-L1 and GFAP were significantly elevated in COVID-19 patients compared to non-COVID-19 controls.” In patients with neurologic symptoms, UCH-L1, but not GFAP, was found to be elevated. The authors recommend adding Neurofilament Light Chain (NfL) to the test since that is associated with brain injury and post-acute COVID as well.
A review from Canada shows that Black individuals with acute COVID infection had substantially higher risk of Venous thromboembolism (VTE) compared to White or Asian people. The authors recommend increasing awareness among Black individuals about the signs of blood clots and educating medical staff about this increased risk.
Fig. 3 Pooled prevalence of VTE in different racial identity groups.
From: https://www.thrombosisresearch.com/article/S0049-3848(24)00159-2/fulltext#%20
A new study from Dr. Ziyad Al-Aly and colleagues at the Veterans Administration hospitals shows that COVID infection is still more deadly than the flu. During the 2022-2023 season, hospitalized COVID patients were at a 61% higher risk of death than those admitted for influenza. In the 2023-2024 respiratory virus season, there was a 35% higher risk of death for patients admitted with COVID infection versus the flu. Overall, the number of deaths was much higher for COVID since there were 2 times more patients with COVID infections admitted to the hospital than were admitted for the flu. As Dr. Al-Aly tweeted,
“1. Covid still leads to more hospitalizations than flu.
2. Covid still leads to more deaths than flu.”
While studying how COVID infection in mice triggers gut impairment, authors found that the SARS-CoV-2 Spike protein induced intestinal chloride secretion causing intestinal edema, and was associated with leukocyte infiltration, reduced glutathione levels, and increased cytokine levels. Gut Paneth cells made less lysozymes, goblet cells made less mucin and jejunal smooth muscle could not contract as well in response to the virus’ spike protein. The mucosal intestinal barrier was disrupted as well.
The NIH and the University of Maryland School of Dentistry found that SARS-CoV-2 infection of acinar cells in human salivary glands leads to a reduction in histatin-5 which allows a concomitant increase in oral Candida Albicans fungal infections.
The FDA issued a warning letter about Cue Health’s home COVID tests last week due to false results. They told people to throw out the tests.
We know that ventilation is important to reduce COVID infections. A new study shows one reason why. It turns out that SARS-CoV-2 can be transmitted to others more easily when the ambient CO2 concentration in the room increases. Higher CO2 levels of even 800 ppm allow SARS-2 to be more aerostable. Therefore, it is critical that we improve indoor air quality to decrease COVID transmission.
This week, I learned about a site called Lit COVID from the NIH. It is a curated hub for articles on all things COVID.
Pediatrics
Twelve months after COVID infection, 7% to 8% of children and young people (CYP) had cognitive impairment. Cognitive dysfunction waxed and waned in some children at different points over the year since acute infection. In general, cognitive impairment was higher in females, those of white race, and kids who were older when they got their first COVID infection. “Consistently at all time-points, CYP experiencing cognitive impairment had worse mental health, were more mentally fatigued, had poorer well-being and more trouble sleeping compared to those who did not experience cognitive impairment.”
An article in the Pediatric Infectious Disease Journal shows that children with Long COVID have impaired exercise capacity. Kids with Long COVID were noted to have a low VO2 peak (oxygen uptake at the peak of exercise) on Cardiopulmonary Exercise Testing (CPET). The study compared sixty-one 12 to 15 year-olds with Long COVID to 30 healthy controls.
Pregnancy
A large study from California compared perinatal health data from 2019 to 2020. It found that "SARS-CoV-2 infection is tied to increased preterm birth (PTB), high blood pressure during pregnancy, and severe maternal morbidity." Of note, COVID vaccination was not available for pregnant individuals until early 2021.
When pregnant individuals infected with asymptomatic or mild COVID infections presented to the hospital in labor, scientists were able to predict the severity of COVID infection at delivery dependent on three variables- gestational age at delivery admission, having a hypertensive disorder in a prior pregnancy, and systolic blood pressure at admission. Using these 3 variables, the model predicted who would go on to have a moderate, severe or critical COVID infection at the time of delivery.
Immunocompromised people
Evusheld had previously been given as pre-exposure prophylaxis to immunocompromised individuals to protect them against COVID infection. However, it was pulled from the market when it no longer worked against newer variants. A new Phase III study shows that a new long acting monoclonal antibody called Sipavibart protected immunocompromised people from COVID infection with newer variants.
Vaccines
A Phase I, first in-human study shows that we may be closer to getting a universal COVID vaccine that could be variant-proof. "SpFN/ALFQ [SARS-CoV-2 vaccine] was well tolerated and elicited robust and durable binding antibody and neutralizing antibody titres against a broad panel of SARS-CoV-2 variants and other sarbecoviruses." Phase I studies are the first step in getting a vaccine approved.
A press release from the European Society of Cardiology meeting shows that COVID-19 vaccination can help people with heart failure live longer and healthier lives. Vaccination was associated with an 82% lower risk of all-cause mortality, 47% lower risk of hospitalization for heart failure, and 13% reduced risk of COVID-19 infection compared with no vaccination.
Long COVID
This week, two conferences with information on Long COVID took place. The PolyBio Spring Symposium reviewed findings from PolyBio researchers on Long COVID. A “mega thread” of 179 tweets on this conference can be found here. The Unite to Fight Conference looking at ME/CFS and Long COVID took place on May 15-16, 2024. Transcripts of that conference should be available in the near future.
Neuro Long COVID
Oftentimes, regular MRIs are read as being normal for Long COVID patients. However, using functional MRI, a group from China compared 25 people who had had mild to moderate COVID infection, 27 who had severe or critical COVID, and 35 healthy controls. Two years after COVID infection, cognitive symptoms were found to be similar after mild COVID and severe COVID- "individuals recovering from [both mild and severe] COVID-19 continue to experience cognitive complaints, psychiatric and neurological symptoms, and brain functional alteration. The rs-fMRI results indicated that the changes in brain function in regions such as the putamen, temporal lobe, and superior parietal gyrus may contribute to cognitive complaints in individuals with long COVID even after 2-year infection."
Figure 2: https://www.thelancet.com/journals/lanwpc/article/PIIS2666-6065(24)00080-4/fulltext#%20
A study previously showed that a leaky blood-brain barrier in combination with inflammation could be the main drivers of cognitive dysfunction in Long COVID in humans. A new study from USC showed that in mice, there was "clear evidence of microvascular damage and breakdown of the blood-brain barrier (BBB)... and the blood-cerebrospinal fluid barrier at the choroid plexus." The leaky BBB and the leaky choroid plexus barrier "may contribute to the neurological complications both acutely and in Long COVID."
In non-COVID news, the CDC unveiled a new wastewater dashboard for Avian Flu Influenza A H5N1. Wastewater testing in Texas has found H5N1 bird flu in 9 Texas cities. The Los Angeles Times reports that some raw milk enthusiasts believe that they will get immunity to H5N1 by drinking infected raw milk, but scientists warn that they might just get very sick.
From: https://www.cdc.gov/nwss/wastewater-surveillance/Flu-A-data.html
A new study shows that for measles vaccination, babies born by cesarean section were 2.6 times less likely to make adequate antibodies after the first dose of the vaccine. After the second dose of vaccine, babies born by c-section did make a normal amount of antibodies.
The Oklahoma State University College of Osteopathic Medicine at the Cherokee Nation opened in 2020. They just graduated their first class of native American medical students.
OSU CENTER FOR HEALTH SCIENCES/MATT BARNARD
When asked what he had been up to prior to his Rookie of the Year press conference, basketball star Victor Wembanyama surprised reporters when he said that he had been explaining dark matter to children at the San Antonio Education Center & Planetarium. NBC wrote, “When LeBron James called Wembanyama an alien, he wasn’t kidding.”
From https://twitter.com/spurs/status/1789449171620991150
Have a great rest of your weekend,
Ruth Ann Crystal MD
COVID news notes:
US Variant tracker: https://covid.cdc.gov/covid-data-tracker/#variant-proportions
Variants around the world: https://outbreak.info/
World wastewater maps (reflects COVID cases): https://www.arcgis.com/apps/dashboards/c778145ea5bb4daeb58d31afee389082
CDC COVID data tracker: https://covid.cdc.gov/covid-data-tracker/index.html#datatracker-home
CDC COVID Hospitalizations (blue) and Emergency Room (orange) visits tracker: https://covid.cdc.gov/covid-data-tracker/index.html#trends_weeklyhospitaladmissions_7dayeddiagnosed_00
This metric has stopped reporting.
US Wastewater Monitoring:
CDC wastewater reporting: https://www.cdc.gov/nwss/rv/COVID19-nationaltrend.html
The last 45 days before 5/11/24
CDC wastewater map: https://www.cdc.gov/nwss/rv/COVID19-currentlevels.html
Biobot: https://biobot.io/data/
The last 6 months of wastewater data:
The last 6 weeks before 5/11/24:
Biobot to stop their COVID wastewater dashboard
National SARS-CoV-2 data from Sara Anne Willette: https://iowacovid19tracker.org/
Through 5/15/24
Hawaii is at “substantial” level for SARS-2, Idaho is “moderate” level
Wastewater SCAN: https://data.wastewaterscan.org/
California statewide view https://buff.ly/3YObiul
Sewer Coronavirus Alert Network (SCAN) project by Stanford University:
Santa Clara County wastewater: https://covid19.sccgov.org/dashboard-wastewater
Marin county: https://coronavirus.marinhhs.org/surveillance
JP Weiland: https://x.com/JPWeiland/status/1791554348893270406
May 17th update:
As anticipated by the April 26th forecast model, cases rose after 4 months of declines.
Up 7% over last week from FLiRT mutations. Still very low infection rates.
174,000 new infections/day
1 in every 192 people currently infected
The impact from FLiRT is not expected to be dramatic, but I still anticipate it to increase infection rates modestly over the next few weeks.
Acute COVID infections, General COVID info
5/13/24 FDA: Do Not Use Cue Health’s COVID-19 Tests Due to Risk of False Results https://buff.ly/3V8aL6l
The FDA issued a Warning Letter to Cue Health on May 10, 2024, after an inspection revealed the company made changes to these tests and these changes reduced the reliability of the tests to detect SARS-CoV-2 virus.
5/14/24 BioRxiV (NIH, U Maryland Dentistry): SARS-CoV-2 Infection of Salivary Glands Predisposes to Oral Candidiasis https://buff.ly/3QT3lRJ
SARS-CoV-2 infection of acinar cells in human salivary glands leads to a reduction in histatin-5 and a concomitant increase in oral Candida Albicans fungal infections.
6/2024 Lancet Neurology: SARS-CoV2- infection as a cause of neurodegeneration https://buff.ly/4bikoF0
https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(24)00178-9/abstract
SARS-CoV-2 infection can cause vascular injury via SARS-2 infection of endothelial cells that line blood vessels and the increased clotting from COVID infection. Even mild COVID infection can lead to neuroinflammation.In vitro, SARS-CoV-2 infection increases clumping of tau protein which can cause Alzheimer’s disease. SARS-CoV-2 viral proteins also contain amyloidogenic regions, which could lead to amyloid formation. The authors state that "SARS-CoV-2 infection should be considered as a risk factor for Alzheimer’s disease, even though the distinction between causation versus disease acceleration is not clear.“
They conclude, “In our opinion, antiviral therapy should be considered even for moderate SARS-CoV-2 infections to reduce the severity of symptoms and limit the likelihood of sequelae.
Patients (especially children and those with postacute sequelae [Long COVID]) should be supported and followed up.”
Figure: Relative risks of (A) neurodegenerative disease and (B) cerebrovascular disease following SARS-CoV-2 infection Risks highlighted in the blue square are relative to other respiratory infections, while other risks are relative to baseline. Younger patients have a greater risk than older patients, and outpatients have higher relative risks than inpatients. Zero relative risk indicates insufficient data. Data for this figure were extracted from Front Neurol 2022; 13: 904796; Brain Behav Immun 2022; 103: 154–62; and J Alzheimers Dis 2022; 89: 411–14. *Patients with subarachnoid haemorrhage.
5/15/24 BMJ: What do we know about Covid-19’s effects on the brain? https://buff.ly/4dHRgbL
Neurologic symptoms, fatigue, difficulty concentrating, and long-term cognitive defects.
Reduction in brain volume related to decrease in neuron cell bodies.
Cytokines may activate astrocytes in the brain causing neuroinflammation.
Low peripheral serotonin reduces vagus nerve signaling to the hippocampus which is involved in learning, memory, and emotion.
Microbleeds and strokes because of COVID's effect on endothelial cells that line blood vessels.
COVID infection probably will increase dementias.
Vaccination may help protect against some brain effects of COVID. Vaccination has been shown to decrease the risk of Long COVID.
5/14/24 Cell: SARS-CoV-2 infection exacerbates the cellular pathology of Parkinson’s disease in human dopaminergic neurons and a mouse model https://buff.ly/3V3pyPm
SARS-CoV-2 infection increases the risk of Parkinson’s disease in human embryonic stem cell (hESC)-derived dopaminergic (DA) neurons and DA neurons in hACE2 Tg mice.
In dopamine neurons, persistent neuroinflammation appears to be mediated by astrocytes and microglia.
CIDRAP: During the 2023-24 respiratory virus season, hospitalized US COVID-19 patients were at a 35% higher risk for death from any cause than those admitted for influenza, compared with a 61% higher risk the winter before.
5/15/24 JAMA: Mortality in Patients Hospitalized for COVID-19 vs Influenza in Fall-Winter 2023-2024 https://buff.ly/3QMwDkR
VA study, Dr. Al-Aly
In the 2023-2024 season n = 8625 participants hospitalized for COVID-19 (death rate, 5.70% at 30 days) and n = 2647 participants hospitalized for seasonal influenza (death rate, 3.04% at 30 days).
There were more than 3x as many hospitalizations for COVID-19 compared with seasonal influenza during 2023-2024.
JN.1 was not more deadly than prior COVID variants.
Dr. Ziyad Al-Aly:
https://twitter.com/zalaly/status/1790761136494694660
“The 35% higher risk of death in people hospitalized for COVID vs flu should be interpreted in the context of 2 times more hospitalizations for Covid than flu.
This compounds the rates of death due to COVID vs flu.”
“Trivializing Covid as an inconsequential “cold” is not based on fact.
Here are the facts:
1. Covid still leads to more hospitalizations than flu
2. Covid still leads to more deaths than flu”
CDC Resp-Net data from Dr. Al-Aly
3/29/24 Mucosal Immunity (Brazil): SARS-CoV-2 Spike protein triggers gut impairment since mucosal barrier to innermost layers: From basic science to clinical relevance https://buff.ly/4bDSV0d
In mice, the SARS-CoV-2 Spike protein (Spk) induced intestinal chloride secretion causing intestinal edema, leukocyte infiltration, reduced glutathione levels, and increased cytokine levels. Gut Paneth cells made less lysozymes, goblet cells made less mucin and jejunal smooth muscle could not contract as well. The mucosal intestinal barrier was disrupted as well by the spike protein.
5/7/24 Lancet (Canada): Venous thromboembolism in Black COVID-19 patients in a minority context compared to White, Asian and other racialized patients: A systematic review and meta-analysis https://www.thrombosisresearch.com/article/S0049-3848(24)00159-2/fulltext#%20
Black individuals with COVID-19 had substantially higher risk of Venous thromboembolism (VTE) compared to White or Asian individuals.
Male participants with COVID-19 presented a higher risk of VTE compared to women.
4/25/24 Nature: Ambient carbon dioxide concentration correlates with SARS-CoV-2 aerostability and infection risk https://buff.ly/3K76FVy
SARS-CoV-2 can be transmitted to others more easily when the ambient CO2 concentration in the room increases. Higher CO2 levels of even 800 ppm allow SARS-2 to be more aerostable. Therefore, it is critical that we improve indoor air quality to decrease COVID transmission.
Lit COVID- a curated literature hub for articles on COVID https://www.ncbi.nlm.nih.gov/research/coronavirus/
Immunocompromised people
5/16/24 Fierce Biotech: AstraZeneca prepares fresh COVID push to regulators after antibody's phase 3 success https://buff.ly/4bkwKMX
Long acting monoclonal antibody Sipavibart was found to protect immunocompromised people from COVID infection. It could replace Evusheld which stopped protecting against newer SARS-CoV-2 variants.
h/t Mary Pope Hardy
Pregnancy
5/16/24 CIDRAP: COVID-19 linked to increased preterm birth, other problems in pregnancy https://buff.ly/4dKmtev
A large study from California comparing data from 2019 to 2020.
"SARS-CoV-2 infection is tied to increased preterm birth (PTB), high blood pressure during pregnancy, and severe maternal morbidity."
Original study: 5/9/24 JAMA: The COVID-19 Pandemic Period, SARS-CoV-2 Infection, and Perinatal Health https://buff.ly/4aooD0r
5/10/24 American Journal of Perinatology: Prediction of COVID-19 Severity at Delivery after Asymptomatic or Mild COVID-19 during Pregnancy https://buff.ly/4bG1B6f
"Among individuals presenting for delivery who had asymptomatic–mild COVID-19, gestational age at delivery admission, a hypertensive disorder in a prior pregnancy, and systolic blood pressure at admission were predictive of delivering with moderate, severe, or critical COVID-19." This prediction model could be used to help triage the pregnant patient.
Pediatrics
5/10/24 Brain, Behavior and Immunity (UK): Prevalence and co-occurrence of cognitive impairment in children and young people (CYP) up to 12-months post infection with SARS-CoV-2 (Omicron variant) https://buff.ly/3QRhYVw
12 months after SARS-CoV-2 infection, around 7 % of children and young people report ‘brain fog’ i.e., cognitive impairment.
2.4% of children and young people experienced persistent cognitive impairment at 3-, 6- and 12-months after SARS-CoV-2 infection.
In children and young people (CYP), cognitive symptoms can wax and wane, but 2.4% had persistent cognitive impairment at 3, 6 and 12 months after COVID infection. At 12 months, 7 to 8% of children and young people had cognitive impairment with more females affected. Cognitive impairment was higher in females, white race, and kids who were older when they got their first COVID infection. “Consistently at all time-points, CYP experiencing cognitive impairment had worse mental health, were more mentally fatigued, had poorer well-being and more trouble sleeping compared to those who did not experience cognitive impairment.”
5/7/24 The Pediatric Infectious Disease Journal: Cardiopulmonary Exercise Testing (CPET) in Children With Long COVID: A Case-controlled Study https://buff.ly/3WKM5SD
n = 61 children with Long COVID vs n = 29 healthy controls
Compared with healthy controls, children with LC have objective impaired functional capacity (expressed by a low VO2 peak), signs of deconditioning and cardiogenic inefficiency when assessed with CPET.
Vaccines
5/15/24 Lancet Microbe: SARS-CoV-2 recombinant spike ferritin nanoparticle vaccine adjuvanted with Army Liposome Formulation containing monophosphoryl lipid A and QS-21: a phase 1, randomized, double-blind, placebo-controlled, first-in-human clinical trial https://buff.ly/3V3f3vN
Working towards a universal COVID vaccine that could be variant-proof. could work against many different SARS-2 variants. In a Phase I study, "SpFN/ALFQ was well tolerated and elicited robust and durable binding antibody and neutralizing antibody titres against a broad panel of SARS-CoV-2 variants and other sarbecoviruses." Phase I studies are the first step in getting a vaccine approved.
5/15/24 CIDRAP: Before vaccines, 44% of COVID-19 patients in ICU died https://buff.ly/3V4E61x
Before vaccines, 18% of hospitalized patients and 44% of COVID ICU patients died.
5/13/24 CIDRAP: Heart-failure patients have 82% better odds of living longer if vaccinated against COVID https://buff.ly/3K1PJzH
Press Release from the European Society of Cardiology meeting: COVID-19 vaccine can help people with heart failure live longer https://buff.ly/4bouHaQ
Antiviral treatments
4/29/24 Nutrients (Italy): The Efficacy of Multivitamin, Vitamin A, Vitamin B, Vitamin C, and Vitamin D Supplements in the Prevention and Management of COVID-19 and Long-COVID: An Updated Systematic Review and Meta-Analysis of Randomized Clinical Trials https://buff.ly/3WGC34P
The effects of vitamin D in preventing COVID-19 and long-COVID were contrasting. Similarly, no conclusion could be drawn on the efficacy of multivitamins, vitamin A, and vitamin B in COVID-19 management.
A few positive findings were reported in some vitamin C trials but results were inconsistent in most outcomes, excluding all-cause mortality (RR = 0.84; 95% CI: 0.72–0.97).
Long COVID
PolyBio Spring Symposium May 17, 2024
Live Tweeted by Patient-Led Research Collab in a Mega Tweet Thread (179 tweets) on research findings from PolyBio researchers
https://x.com/patientled/status/1791515331174772959
https://x.com/PeteCaruso_/status/1791541847904358836
One of 4 new studies at UCSF.
Anktiva, a IL-15 agonist
Unite to Fight Conference May 15-16, 2024. Transcripts will be available in the future.
5/14/24 The Sick Times: Should people with Long Covid be donating blood? https://buff.ly/4bEF89G
Neuro Long COVID
MGH in Boston is doing an MRI study of people with Long COVID and healthy controls. https://redcap.bumc.bu.edu/surveys/?s=CTXM4PH8HD4KW9ND
From
https://twitter.com/ChristaHagearty/status/1790030328196657384
5/9/24 Lancet Western Region (China): Brain abnormalities in survivors of COVID-19 after 2-year recovery: a functional MRI study https://www.thelancet.com/journals/lanwpc/article/PIIS2666-6065(24)00080-4/fulltext#%20
n = 25 mild-moderate COVID, n = 27 severe-critical COVID patients followed for 2 years compared to n = 35 healthy controls.
Participants underwent cognitive testing and resting-state functional magnetic resonance imaging (rs-fMRI) of the brain 2 years after COVID infection.
Cognitive symptoms were similar after mild COVID and severe COVID.
Two years after acute COVID infection, "individuals recovering from [both mild and severe] COVID-19 continue to experience cognitive complaints, psychiatric and neurological symptoms, and brain functional alteration. The rs-fMRI results indicated that the changes in brain function in regions such as the putamen, temporal lobe, and superior parietal gyrus may contribute to cognitive complaints in individuals with long COVID even after 2-year infection."
h/t Dani Beckman:
https://twitter.com/DaniBeckman/status/1790016502353084581
Figure 2: https://www.thelancet.com/journals/lanwpc/article/PIIS2666-6065(24)00080-4/fulltext#%20
5/3/24 MedRxiV: An FDA-approved assay platform can detect biomarkers of neuronal and glial injury in the blood of COVID-19 patients https://buff.ly/3wvmZMM
5/7/24
https://twitter.com/DaniBeckman/status/1788086620685533595
Tweet from @DaniBeckman
Repurposing of an FDA-approved platform developed for traumatic brain injury (TBI) can detect early neurological injury in the blood of COVID19 patients.
Analysis of two markers for brain damage in the blood:
UCH-L1 (neuron death) and GFAP (astrocytes, neuroinflammation) found:
Marked statistical differences in the UCH-L1 levels at early time points in COVID-19 patients were detected even without clear neurological alterations.
Levels of GFAP in COVID-19 patients were only exceeded by levels in hemorrhagic stroke patients.
The study by @Alex_Glushakov and colleagues can be found here: https://medrxiv.org/content/10.1101/2024.05.02.24306477v1
2/10/24 BioRxiV (USC): SARS-COV-2 induces blood-brain barrier and choroid plexus barrier impairments and vascular inflammation in mice https://buff.ly/44Gxzx8
In mice, there was "clear evidence of microvascular damage and breakdown of the blood-brain barrier (BBB)... and the blood-cerebrospinal fluid barrier at the choroid plexus." This "may contribute to the neurological complications both acutely and in long COVID."
5/10/24 Nature: In-vitro and in-vivo assessment of nirmatrelvir (Paxlovid component) penetration into CSF, central nervous system cells, tissues, and peripheral blood mononuclear cells https://buff.ly/4bufxAm
nirmatrelvir/ritonavir (NMR/RTV), a.k.a. Paxlovid
In rats, only about 16% of plasma Paxlovid crossed into the brain.
Other news:
NEW Avian Flu H5N1 Influenza A https://www.cdc.gov/nwss/wastewater-surveillance/Flu-A-data.html
Influenza A
5/13/24 CIDRAP: Wastewater testing finds H5N1 avian flu in 9 Texas cities https://buff.ly/44JGE8m
5/12/24 LA Times: Despite H5N1 bird flu outbreaks in dairy cattle, raw milk enthusiasts are uncowed https://buff.ly/3wCTQzg
Some raw milk enthusiasts believe that they will get immunity to H5N1 by drinking infected raw milk, but scientists warn that they might just get very sick.
North Carolina bill making masking illegal, except if you are the KKK
https://x.com/luckytran/status/1791194238736101619
5/13/24 Nature Microbiology: Dynamics of measles immunity from birth and following vaccination https://buff.ly/3K3OkJ5
For measles vaccination, babies born by cesarean section were 2.6 times less likely to make adequate antibodies after the first dose of the measles vaccine. However, after the second dose of vaccine, babies born by c-section did make robust antibodies.
5/13/24 Healthcare IT News: AHA, H-ISAC warn hospitals about Russian-based Black Basta following Ascension cyberattack https://buff.ly/3yaxplh
At least two healthcare organizations "in Europe and in the United States" saw serious operational disruptions in the past month after being hit with Black Basta ransomware
5/16/24 STAT News: The only tribal medical school in the U.S. graduates its first Native American doctors https://buff.ly/44OSqhU
The Oklahoma State University College of Osteopathic Medicine at the Cherokee Nation started in 2020 and just graduated their first class.
5/12/24 NBC: Victor Wembanyama explained dark matter during his Rookie of the Year press conference https://buff.ly/3UIdrGd
As ever, thank you for your work and care.
The Idaho Covid link goes to Iowa. Which did you intend?