COVID news & more, 7/13/24

We are officially in a COVID wave right now. The CDC reports that wastewater levels of SARS-CoV-2 are HIGH on a national level. COVID test positivity is increasing, as are emergency department visits for COVID infections. Hospitalization data is not being reported by most states. The CDC is only updating variant proportions every two weeks- last time it was reported was on July 6,2024. KP.3 and its descendent KP.3.1.1 are pushing out other variants on the mainland United States, as it has done in other countries and in Hawaii. 

From: https://www.cdc.gov/nwss/rv/COVID19-nationaltrend.html

Sara Anne Willette broke down the CDC NWSS data further showing that as of 7/13/24, wastewater SARS-CoV-2 in

• Oregon and Florida are “EXCESSIVELY HIGH” (blue)

• Nevada is “VERY HIGH” (purple)

• California, Texas, Arkansas, Maryland are “HIGH” (pink)

  

From https://iowacovid19tracker.org/

The highest wastewater levels of SARS-2 in America per WastewaterSCAN are:

• SW St Petersburg FL 3199 PMMoV, 

• Roswell GA 2847 PMMoV, 

• East Orange County FL 2567 PMMoV, 

• East Bank New Orleans LA 2494 PMMoV, 

• Wolcott Kansas City KS 2338 PMMoV, 

• NW St Petersburg FL 1865 PMMoV, 

• Millbury MA 1816 PMMoV, 

• Portland ME 1815 PMMoV, 

• Oceanside San Francisco CA 1513 PMMoV, 

• Woodlands Texas TX 1378 PMMoV 

As of July 13 in California, 

• San Francisco and Sacramento counties have EXCESSIVELY HIGH (blue) SARS-CoV-2

• Santa Clara County is VERY HIGH (purple on map) wastewater levels of SARS-CoV-2

• San Mateo, Napa, Yolo and Yuba counties have HIGH (pink on map) SARS-CoV-2

From https://iowacovid19tracker.org/

In his July 12 update, JP Weiland reports that across the US 1 in every 54 people currently infected with COVID. Regionally, he reports that the ratio of people currently infected is

• Midwest:   1 in 79  

• South:        1 in 43    

• Northeast:  1 in 79  

• West:          1 in 37   

Weiland also forecasts that COVID cases will be peaking on the West Coast soon, in the South in late July, and the Northeast/Midwest cases will peak in August.

From: https://twitter.com/JPWeiland/status/1811844706940465498

Acute COVID and General COVID

A new study shows that the Histamine H1 receptor can act as an independent receptor for the SARS-CoV-2 virus to enter human cells and it can also help SARS-CoV-2 to enter cells via the ACE2 receptor. Using antihistamine drugs that block the H1 receptor can block the entry of the COVID virus into cells and may be able to help reduce COVID infections.

Social and Advocacy

This week, 18 year old Violet Affleck (daughter of Ben Affleck and Jennifer Garner) spoke at the Los Angeles County Board of Supervisors meeting. In 60 seconds, she was able to advocate for improved indoor air quality, show support for health equity and eloquently express her opposition to mask bans.

This week, the hashtag #YallMasking was trending on social media to increase awareness of the present COVID wave and the need to wear masks to help reduce the spread of disease. 

From https://x.com/morgfair/status/1810854263519858731

Pregnancy

A new study shows that Long COVID may be slightly more prevalent among people infected while pregnant. With common symptoms of postexertional malaise, fatigue, and gastrointestinal symptoms, Long COVID could make it very hard to take care of an infant or toddler.

Seniors

A new study from Chongqing, China looked at 1,245 people aged 60 years or older who had the original SARS-CoV-2 strain as compared to 358 uninfected spouses. People with severe COVID-19 often showed signs of cognitive decline in the first year after getting infected, but decline appeared to slow after that. Having severe COVID infection, cognitive problems at six months, and high blood pressure were linked to ongoing cognitive decline in seniors. 

Pediatrics

Children are exposed to many different bacterial and viral infections which often cause asymptomatic infections. The constant activation of the immune system in children allows them to be better equipped to fight off new infections. A new study shows that co-infections of bacteria or viruses during COVID infection appear to boost nasal mucosal immunity in children, allowing them to be more resistant to COVID infections.

On a state level, higher COVID vaccination rates in children protected against symptomatic asthma. Not only did COVID vaccination protect individual children against COVID infection, but COVID vaccination was found to protect against other human coronaviruses such as the common cold virus, by producing cross-reactive antibodies. In states with higher vaccination rates, community-level immunity may have helped reduce children’s asthma risk.

While older children lost math and reading skills during the pandemic, kids who were babies or toddlers during the height of the pandemic are now struggling in kindergarten. Kindergarten teacher Brook Allen relayed that “several students could barely speak, several were not toilet trained, and several did not have the fine motor skills to hold a pencil.” Swiping on smartphones and tablets instead of practicing fine motor skills like drawing shapes or letters has caused these children to fall behind significantly. If given extra help, these kids will hopefully catch up as older peers have in their classes.

Vaccines

A new NIH clinical trial is enrolling at Baylor, Emory and NYU for a Phase I trial to test a new nasal COVID vaccine in people who have had at least three prior doses of COVID vaccines via injection. The hope is that the nasal vaccine may work on many different future COVID variants to reduce COVID infections and transmission.

Antivirals treatments

Shanker and colleagues used artificial intelligence to help engineer antibodies that had improved binding and better virus neutralization against various SARS-CoV-2 variants. “These results demonstrate the potential for machine learning and protein language models trained on protein sequence information to contribute to protein engineering tasks even in the absence of task-specific training data."

Monocytes can become dysregulated during severe COVID infections. Giving dexamethasone helped to reverse the pro-inflammatory responses of monocytes in severe COVID.

Long COVID

Using a special Immuno PET scan with radioactively tagged T cells, researchers from UCSF show that SARS-CoV-2 can persist chronically in the gastrointestinal system and in other organs of people with Long COVID for over 2 years. For people with brain fog and fatigue, the gut and the spinal cord lit up on Immuno PET scan. Those with lingering pulmonary symptoms had immune activation in their lungs. Long COVID patient Ezra shows his Immuno PET scan from the study and explains the findings in a fascinating video here.

Using a new technique called MENSA, Media Enriched with Newly Synthesized Antibodies, researchers from Emory University looked at antibodies made from circulating human plasmablasts to provide a current “immune snapshot” of viral triggers. If they had looked at antibodies in the blood without the MENSA technique, they would see antibodies to past illnesses and vaccines as well as those to current infections.

The authors found that 40% of Long COVID patients were MENSA positive for SARS-CoV-2 persistence compared to none of the COVID recovered patients. In addition, MENSA tests were also positive for persistence or for reactivation of Epstein-Barr Virus (EBV) in 37%, Cytomegalovirus (CMV) in 23% and herpes simplex virus 2 (HSV2) in 15% of the people with Long COVID. In COVID recovered controls, only 17% were positive for EBV, 4% were positive for CMV and 4% were positive for HSV-2.

Graphic abstract from https://www.medrxiv.org/content/10.1101/2024.07.05.24310017v1

A study of EHR records from 3 million people showed that people often have COVID reinfection symptoms in a similar severity to their first COVID infection. Long COVID was found to be more common after the first COVID infection compared to reinfections during the Omicron period.

Long COVID may be a chronic relapsing and remitting disease. “People who have recovered from Long COVID can suffer relapses or flare-ups from new viral infections — not just from COVID but from cold, flu, and other viral pathogens, researchers have found.” Dr. Alba Azola said that anecdotally, flare-ups seem to occur more commonly in people who had autonomic dysfunction or ME/CFS symptoms with Long COVID.  Dr. Putrino added that Long COVID patients can "recover (or feel recovered) from long COVID until the next immune challenge — another COVID infection, flu infection, pregnancy, food poisoning (all examples we have seen in the clinic) — and experience a significant flare-up of your initial COVID infection." Relapses may be short-lived in some. 

ASIA syndrome (Autoimmune/inflammatory Syndrome Induced by Adjuvants (ASIA), also known as Shoenfeld’s syndrome, includes several autoimmune conditions that can happen after exposure to substances with adjuvant activity. Adjuvants are added to some vaccines to increase immune response, but rarely it can cause ASIA syndrome. Viral persistence can act like an adjuvant to cause the syndrome as well. 

A group from Spain proposed a model to explain possible ASIA syndrome in Long COVID, ME/CFS and post-COVID vaccine syndrome. Abnormal CD4 T cell responses may lead to CD8 T cell hyperactivation and also to autoantibodies against the part of the pituitary gland that makes the ACTH hormone. The inflammation in the pituitary (hypophysitis) from these autoantibodies could lead to decreased production of ACTH in the pituitary which then leads to decreased cortisol production from the adrenal glands.

The authors review a multitude of pathways (see Figure 1 below which is one of the busiest diagrams that I have ever seen) and propose that “treatment with antivirals, corticosteroids/ginseng, antioxidants, and metabolic precursors could improve symptoms by modulating the immune response, pituitary function, inflammation and oxidative stress.” 

Figure 1 Schematic model of the development and treatment of long COVID, post-COVID-19 vaccine syndrome and myalgic encephalomyelitis/chronic fatigue syndrome.

From: https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2024.1422940/full

Neutrophil Extracellular Traps (NETs) appear to stabilize fibrin amyloid microclots (FAM) in people with Long COVID which can cause blockage of capillaries and reduced oxygen delivery to tissues. The fibrinolytic-resistant FAM microclots trap inflammatory molecules including proteins that prevent clot breakdown. The spike protein from the SARS-CoV-2 virus can induce fibrinolytic-resistant FAM as well. High FAM in the blood of people with Long COVID can increase the amount of microclotting in small blood vessels and can increase Long COVID pathology.

H5N1

The Department of Public Health in Colorado reported that 3 people who worked with chickens at an infected egg laying facility have H5N1 avian flu. Up to 55 people have symptoms and are being tested this weekend.

Avian H5N1 influenza usually binds to α2,3-linked sialic acid receptors in birds. But, the virus has mutated in cows and now can link to α2,6-linked sialic acid receptors. This is very concerning because there are high levels of α2,6-linked sialic acids in the upper respiratory tract of humans. This mutation in the H5N1 influenza A can make it more easy to transmit among humans and some other mammals.

Other news

A new study reports an association between GLP-1 medication semaglutide and Nonarteritic Anterior Ischemic Optic Neuropathy (NAION) which can cause blindness. The increase in NAION was seen in people with Type II diabetes as well as those taking semaglutide for obesity.

Researchers found that an imbalance in types of T cells is a root cause of Lupus. 

The hormone CCN3 is produced during lactation and helps breastfeeding women to maintain strong bones even though they lose calcium into their milk. “Based on this discovery, they now refer to CCN3 as Maternal Brain Hormone (MBH).”

In Idaho, a pregnant woman started hemorrhaging and leaking amniotic fluid at 20 weeks gestation in her third pregnancy and she needed an emergency abortion. The doctor put her on a plane to another state instead of treating her.

This week, Bloomberg Philanthropies donated $1 Billion to Johns Hopkins for medical student tuition and for financial aid for nursing and public health students as well. 

The original Dr. Ruth passed away yesterday at age 96. Dr. Ruth Westheimer was a Holocaust orphan, a single mother, and a student who received her doctorate in education from Columbia University before doing a postdoc in sex therapy. A witty and endearing person, she will be dearly missed. 

Have a good rest of your weekend,

Ruth Ann Crystal MD

---

COVID news notes:

US Variant tracker: https://covid.cdc.gov/covid-data-tracker/#variant-proportions

Same as last week. Not updated.

Estimates through 7/6/24. Variants reported every 2 weeks now.

Over the last 4 weeks:

• KP.3 went from 17% to 24.5% to 31.3% to 36.9%

• KP.2 went from 19.4% to 21.5% to 24.3% to 24.4%

• LB.1 went from 8.0% to 10% to 13% to 14.9%

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

Through 7/6/24

Walgreens positivity rate: https://www.walgreens.com/businesssolutions/covid-19-index.jsp

US Wastewater Monitoring:

CDC wastewater reporting: https://www.cdc.gov/nwss/rv/COVID19-nationaltrend.html

NEW: Updated 7/11/24

CDC wastewater map: https://www.cdc.gov/nwss/rv/COVID19-currentlevels.html

• Wastewater updated 7/11/24 

Wastewater Data from Sara Anne Willette:  https://iowacovid19tracker.org/

CDC NWSS Wastewater SARS-CoV-2 as of 7/13/24

• Oregon and Florida are EXCESSIVELY HIGH (blue)

• Nevada is VERY HIGH

• California, Texas, Arkansas, Maryland are HIGH

  

California Wastewater SCAN as of July 13

• San Francisco and Sacramento have EXCESSIVELY HIGH SARS-CoV-2

• Santa Clara County is VERY HIGH wastewater levels of SARS-CoV-2

• San Mateo, Napa, Yolo and Yuba counties have HIGH SARS-CoV-2

Wastewater SCAN nationally:

Wastewater SCAN: https://data.wastewaterscan.org/

Los Angeles

Monterey and Santa Cruz, CA

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://twitter.com/JPWeiland

July 12th update: https://twitter.com/JPWeiland/status/1811844706940465498

“Wow! After a week off of reporting, the CDC posted a large increase in wastewater levels, and retroactively increased earlier levels. 

• 620,000 new infections/day 

• 1 in every 54 people currently infected 

• 15% higher than 12 month avg.”

Ratio of people currently infected by region:

• Midwest:   1 in 79  

• South:        1 in 43    

• Northeast:  1 in 79  

• West:          1 in 37   

US Forecast:

Increasing cases expected into late July, with the West Coast peaking shortly, the South peaking in late July, and the Northeast/Midwest in August.

Michael Hoerger modeling:  http://pmc19.com/data/, https://twitter.com/michael_hoerger/status/1810531713543733514

7/6/24 https://twitter.com/zalaly/status/1809686013478088909

Acute COVID and General COVID

7/2/24 mBio: The histamine receptor H1 acts as an alternative receptor for SARS-CoV-2 https://buff.ly/3LecRf3

The Histamine H1 receptor can act as an independent receptor for the SARS-CoV-2 virus to enter human cells and it can also help SARS-CoV-2 to enter cells via the ACE2 receptor. Using antihistamine drugs that block the H1 receptor can block the entry of the COVID virus into cells and may be able to help reduce COVID infections.

7/4/24 Cell Communication and Signaling: SARS-CoV-2-associated lymphopenia: possible mechanisms and the role of CD147 https://buff.ly/4cToSCt

Social and Advocacy

18 year old Violet Affleck (daughter of Ben Affleck and Jennifer Garner) spoke at the Los Angeles County Board of Supervisors meeting this week. In 60 seconds, she was able to advocate and express her opposition to mask bans.

Her speech:

"Violet Affleck, Los Angeles resident, first-time voter age 18.

I contracted a post-viral condition in 2019. I'm OK now, but I saw first-hand that medicine does not always have answers to the consequences of even minor viruses. The COVID-19 pandemic has thrown that into sharper relief.

One in 10 infections leads to Long COVID, which is a devastating neurological [and] cardiovascular illness that can take away people's ability to work, move, see, and even think.

It stands to exacerbate our homelessness crisis as well as the suffering of many people in our city. It hits people of color, disabled people, elderly people, trans people, women and anyone in a public facing essential job the hardest. 

To confront the Long COVID crisis, I demand mask availability, air filtration and far-UVC light in government facilities, including jails and detention centers, and mask mandates in county medical facilities. 

We must expand the availability of high-quality free tests and treatment and, most importantly, the county must oppose mask bans for any reason. They do not keep us safer, they make vulnerable members of our community less safe and make everyone less able to participate in Los Angeles together. Thank you.”

Pregnancy

7/11/24 Washington Post: 1 in 10 people infected during pregnancy develop long covid, study finds https://buff.ly/3S3Nkc8 or https://archive.is/Bakj1

“Nearly 1 in 10 people infected with the coronavirus during pregnancy developed long covid, according to a study.” The research “suggests long covid is more prevalent among people infected while pregnant than in the population overall.” ACOG fellow Cynthia Abraham, MD, said, “A lot of the data we have is from nonpregnant populations...so this paper hones in on a significant population that’s been understudied.” 

7/11/24 Obstetrics & Gynecology: Post–Acute Sequelae of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) After Infection During Pregnancy https://buff.ly/3WnFpJz

The prevalence of PASC at a median time of 10.3 months after SARS-CoV-2 infection during pregnancy was 9.3% in the NIH RECOVER-Pregnancy Cohort. The predominant symptoms were postexertional malaise, fatigue, and gastrointestinal symptoms. Several socioeconomic and clinical characteristics were associated with PASC after infection during pregnancy. 

Seniors

7/10/24 Nature Aging (China): Tracking cognitive trajectories in older survivors of COVID-19 up to 2.5 years post-infection https://buff.ly/3Wi2yNd

Having severe COVID infection, cognitive problems at six months, and high blood pressure were linked to ongoing cognitive decline. 

Pediatrics

7/3/24 JAMA: COVID-19 Vaccination and Parent-Reported Symptomatic Child Asthma Prevalence https://buff.ly/3xQ0hj4

On a state level, higher COVID vaccination rates in children protected children against symptomatic asthma. Not only did COVID vaccination protect individual children against COVID infection, but COVID vaccination was found to protect against other human coronaviruses such as the common cold virus, by producing cross-reactive antibodies. In states with higher vaccination rates, community-level immunity may have helped reduce children’s asthma risk.

7/1/24 NY Times: The Youngest Pandemic Children Are Now in School, and Struggling https://buff.ly/3xGjqno

Brook Allen, in Martin, Tenn., has taught kindergarten for 11 years. This year, for the first time, she said, several students could barely speak, several were not toilet trained, and several did not have the fine motor skills to hold a pencil.

7/1/24 Journal of Experimental Medicine: High burden of viruses and bacterial pathobionts drives heightened nasal innate immunity in children https://buff.ly/3L6OSyb

• n = 467 children. Data from 2021 and 2022.

• These findings reveal that frequent, dynamic host–pathogen interactions drive nasal innate immune activation in children.

• Children are exposed to many different bacterial and viral infections which often cause asymptomatic infections. The constant activation of the immune system in children allows them to be better equipped to fight off new infections. Co-infections of bacteria or viruses during COVID infection appear to boost nasal mucosal immunity allowing children to be more resistant to COVID infections.

Vaccines

7/1/24 NIH-sponsored trial of nasal COVID-19 vaccine opens https://buff.ly/3XHATXl

• The study aims to enroll 60 adult participants, ages 18 to 64 years old, who previously received at least three prior doses of an FDA-approved or -authorized mRNA COVID-19 vaccine. 

• The trial sites are Baylor College of Medicine, Houston; The Hope Clinic of Emory University, Decatur, Georgia; and New York University, Long Island. 

Antiviral treatments

This week, the hashtag #YallMasking was trending on social media to increase awareness of the present COVID wave.

https://x.com/morgfair/status/1810854263519858731

7/4/24 Science: Unsupervised evolution of protein and antibody complexes with a structure-informed language model https://buff.ly/3VRU9Pn

Shanker and colleagues used artificial intelligence to help engineer antibodies that had improved binding and better virus neutralization against various SARS-CoV-2 variants. 

• In silico antibody engineering by artificial intelligence

7/3/24 Cell: The life-saving benefit of dexamethasone in severe COVID-19 is linked to a reversal of monocyte dysregulation https://buff.ly/4ctDFUt

Monocytes can become dysregulated during severe COVID infections. Giving Dexamethasone helped to reverse the pro-inflammatory responses of monocytes. 

Long COVID

7/3/24 Science (Peluso et al.): Tissue-based T cell activation and viral RNA persist for up to 2 years after SARS-CoV-2 infection https://buff.ly/3VR5T4I

Using a special PET scan with radioactively tagged T cells, researchers from UCSF show that SARS-CoV-2 can persist chronically in the gastrointestinal system and in other organs of people with Long COVID for over 2 years. For people with brain fog and fatigue, the gut and the spinal cord lit up on Immuno PET scan. Those with lingering pulmonary symptoms had immune activation in their lungs. 

This video by Long COVID patient Ezra on the UCSF Immuno PET scan study for activated T cells explains it really well.

7/8/24 Frontiers in Immunology (Spain): Hypocortisolemic ASIA: a vaccine- and chronic infection-induced syndrome behind the origin of Long COVID and myalgic encephalomyelitis https://buff.ly/3WfG5k1

• ASIA syndrome (Autoimmune/inflammatory Syndrome Induced by Adjuvants (ASIA), also known as Shoenfeld’s syndrome, includes several autoimmune conditions that can happen after exposure to substances with adjuvant activity. Viral persistence can act like an adjuvant to cause the syndrome.

• A group from Spain proposed a model to explain the ASIA syndrome in Long COVID, ME/CFS and post-COVID vaccine syndrome. Abnormal CD4 T cell responses may lead to CD8 T cell hyperactivation and also to autoantibodies against the part of the pituitary gland that makes the ACTH hormone. The inflammation in the pituitary (hypophysitis) from these autoantibodies could lead to decreased production of ACTH in the pituitary which then causes decreased cortisol production from the adrenal glands.

• They review a multitude of pathways (see Figure 1 which is one of the busiest diagrams that I have ever seen) and propose that “treatment with antivirals, corticosteroids/ginseng, antioxidants, and metabolic precursors could improve symptoms by modulating the immune response, pituitary function, inflammation and oxidative stress.” 

Figure 3 Developmental model of long COVID, ME/CFS and post-COVID-19 vaccine syndrome: Impact of HLA-DR15 on the immune response and molecular mimicry. 

The pituitary gland makes many different hormones:

Wikipedia photo credit: Richard E. Jones, Kristin Lopez: Human Reproductive Biology, page 14 

This paper includes one of the most complicated diagrams I have ever seen! 

Figure 1 Schematic model of the development and treatment of long COVID, post-COVID-19 vaccine syndrome and myalgic encephalomyelitis/chronic fatigue syndrome.

7/7/24 MedRxiV (Emory University): MENSA, a Media Enriched with Newly Synthesized Antibodies, to Identify SARS-CoV-2 Persistence and Latent Viral Reactivation in Long-COVID https://buff.ly/3WiGYbH

Using a new technique which they call MENSA, Media Enriched with Newly Synthesized Antibodies, researchers from Emory University looked at antibodies made from circulating human plasmablasts to provide a current “immune snapshot” of viral triggers happening in the present.

They found that 40% of Long COVID patients were MENSA positive for SARS-CoV-2 compared to none of the COVID recovered patients. This shows that there is ongoing inflammation being caused by SARS-2 in Long COVID. 

Combined, a total of 60% of PASC patients have a positive MENSA for SARS2, EBV, CMV, and/or HSV2. 

Graphical Abstract: 

7/11/24 Nature Communications: Insights from an N3C RECOVER EHR-based cohort study characterizing SARS-CoV-2 reinfections and Long COVID https://buff.ly/4cEfmTS

A study of EHR records from 3 million people showed that people often have COVID reinfection symptoms in a similar severity to their first COVID infection. Long COVID was found to be more common after the initial COVID infection compared to reinfections during the Omicron period.

7/3/24 Medscape: Cold, Flu Virus Can Trigger Long COVID Relapses https://buff.ly/3LlrBJa

Long COVID may be a chronic relapsing and remitting disease. “People who have recovered from Long COVID can suffer relapses or flare-ups from new viral infections — not just from COVID but from cold, flu, and other viral pathogens, researchers have found.” 

7/3/24 Research Square (Pretorius et al.): Circulating microclots are structurally associated with Neutrophil Extracellular Traps and their amounts are strongly elevated in long COVID patients https://buff.ly/3S5Sp3X

7/2024 Transfusion: SARS‐CoV‐2 antibody levels and Long COVID occurrence in blood donors https://buff.ly/3LidzIj

• "Anti-SARS-CoV-2 antibodies were time-dependently associated with long COVID; higher anti-nucleocapsid levels were associated with higher risk; and higher anti-spike levels were associated with lower risk of longCOVID." 

7/1/24 CAN-PCC Collaborative recommends Metformin treatment for people with PCC (Long COVID) if they have a new COVID infection.

https://buff.ly/3S2im4u

https://can-pcc.recmap.org/recommendation/a5a56fe7-3266-4854-8c91-036e572cf71c

“In adults with post COVID-19 condition who have a new COVID-19 infection, the CAN-PCC Collaborative suggests using metformin (conditional recommendation; very low certainty in the evidence). Remarks: The regimen of metformin that was used in the two largest RCTs in non-hospitalized adults with acute COVID-19 was 750 mg twice daily for 10 days in one study, while the other study used a gradually increased dose (day 1: 500 mg once, day 2-5: 500 mg twice daily, day 6-14: 500 mg in the morning and 1000 mg in the evening). This recommendation specifically applies to adults and not to children and adolescents.” 

ME/CFS 

6/28/24 BioMapAI: Artificial Intelligence Multi-Omics Framework Modeling of Myalgic Encephalomyelitis / Chronic Fatigue Syndrome https://buff.ly/4cGp483

H5N1

7/13/24 H5N1 HPAI in cows

7/12/24 Colorado state health officials identify possible human cases of avian flu in Colorado poultry workers https://buff.ly/3W5fYeo

Three people who worked with chickens at an egg laying facility have H5N1 avian flu. Up to 55 people have symptoms and are being tested this weekend.

7/8/24 Nature: Pathogenicity and transmissibility of bovine H5N1 influenza virus https://buff.ly/4646qon

Avian H5N1 influenza usually binds to α2,3-linked sialic acid receptors in birds. But, the virus has mutated in cows and now can link to α2,6-linked sialic acid receptors. This is very concerning because there are high levels of α2,6-linked sialic acids in the upper respiratory tract of humans. This mutation in the H5N1 influenza A can make it more easy to transmit among humans and possibly other mammals.

7/2/24 PBS: U.S. government will pay Moderna $176 million to develop an mRNA bird flu pandemic vaccine https://buff.ly/3xQtGti

7/3/24 CNN: Fourth human case of bird flu connected to dairy cattle outbreak in Colorado identified in the US https://buff.ly/3xOAlEp

• More than a quarter of dairy herds in Colorado have reported cases of bird flu.

• The infected person in Colorado had mild symptoms, reporting only conjunctivitis, or pink eye, as a symptom. 

Avian Flu H5N1 Influenza A https://www.cdc.gov/nwss/wastewater-surveillance/Flu-A-data.html

AI:

7/7/24 TIME: AI-Driven Behavior Change Could Transform Health Care https://buff.ly/4bAlV8H

• Sam Altman and Ariana Huffington present Thrive AI Health for behavioral change for chronic diseases.

Other news:

7/10/24 NBC: Scientists say they have identified a root cause of Lupus — one that could pave the way for new treatments https://buff.ly/4f0gEKM

• "People with lupus have too much of a particular T cell associated with damage in healthy cells and too little of another T cell associated with repair."

7/10/24 UCSF: Scientists Discover a New Hormone that Can Build Strong Bones https://buff.ly/4cTiGKE

Researchers at UCSF and UC Davis solved a long-standing puzzle on how the bones of breastfeeding women stay strong even as they lose calcium to milk.

Hormone CCN3 is only produced during lactation helps to build bone.

7/8/24 NBC: Santa Clara County health leaders warn of possible Measles exposure https://buff.ly/3W0LXw1

The adult person who had measles was at the Starbucks on Blossom Hill Road in Los Gatos on July 1st between 9:30 and 11:30 a.m. They then dined at Taqueria Los Pericos on Water Street in Santa Cruz from 6 to 10 p.m. On July 2, they went to San Jose airport from 5:15 to 7:30 a.m. before catching a Southwest flight to Chicago. 

7/3/24 JAMA Ophthalmology (Harvard): Risk of Nonarteritic Anterior Ischemic Optic Neuropathy (NAION) in Patients Prescribed Semaglutide https://buff.ly/3xLR37m

• retrospective matched cohort study 16 827 patients, 710 had T2D (194 prescribed semaglutide; 516 prescribed non–GLP-1 RA antidiabetic medications

• The cumulative incidence of NAION for the semaglutide vs non–GLP-1 RA cohorts over 36 months was 6.7% and 0.8%, respectively.

• "This study’s findings suggest an association between semaglutide and NAION. As this was an observational study, future study is required to assess causality." 

7/8//24 TIME: Inside the 'Nightmare' Health Crisis of a Texas Bitcoin Town https://buff.ly/45ZsiBy

The Bitcoin mine is causing a low humming noise that is making some residents of the town very sick.

6/8/24 NY Times: She Needed an Emergency Abortion. Doctors in Idaho Put Her on a Plane. https://buff.ly/45RRVnE

Hemorrhaging and leaking amniotic fluid at 20 weeks gestation.

“If I need saving, you’re not going to help me?” she recalls asking. She remembers his answer vividly: “He told me he wasn’t willing to risk his 20-year career.” So he put her on a plane to Utah.

7/8/24 Bloomberg Philanthropies donates $1 Billion to Johns Hopkins for medical student tuition and for nursing and public health students.

7/13/24 NY Times: Ruth Westheimer, the Sex Guru Known as Dr. Ruth, Dies at 96 https://buff.ly/3LjI54y

Speed Bump Cartoon (via Eric Topol)