Study investigates 12-month respiratory outcomes in patients hospitalized for COVID-19

A new study has shown that most patients discharged from hospital after experiencing severe COVID-19 infection appear to return to full health, although up to a third do still have evidence of effects upon the lungs one year on.

COVID-19 has infected millions of people worldwide. People are most commonly hospitalized for COVID-19 infection when it affects the lungs – termed COVID-19 pneumonia. Whilst significant progress has been made in understanding and treating acute COVID-19 pneumonia, very little is understood about how long it takes for patients to fully recover and whether changes within the lungs persist.

In this new study, published in The Lancet Respiratory Medicine, researchers from the University of Southampton worked with collaborators in Wuhan, China, to investigate the natural history of recovery from severe COVID-19 pneumonia up to one year after hospitalization.

83 patients were recruited after they were discharged from hospital following severe COVID-19 pneumonia and were followed up after three, six, nine and twelve months. At each time point they underwent clinical assessment as well as measures of how well the lungs function, a CT scan of their chest to take a picture of the lungs, and a walking test.

Over 12 months in most patients there was an improvement in symptoms, exercise capacity, and COVID-19 related CT changes. By 12 months the majority of patients appeared to have fully recovered although about 5% of patients still reported breathlessness. A third of patients' measures of lung function were still reduced – in particular how efficiently oxygen is transferred in the lungs into the blood – and this was more frequently found in women than in men. In around a quarter of patients CT scans showed there were still small areas of change in the lungs, and this was more common in patients with more severe lung changes at time of hospitalization.

Dr Mark Jones, Associate Professor in Respiratory Medicine at the University of Southampton and NIHR Southampton Biomedical Research Centre who co-led the study said, "the majority of patients with severe COVID-19 pneumonia appeared to fully recover, although for some patients this took many months. Women were more likely to have persistent reductions in lung function tests and further investigation is needed to understand if there is a sex specific difference in how patient's recover. We also don't yet know what happens beyond 12 months and this will need ongoing study."

The researchers acknowledged that this study only involved a small number of patients and the findings will require confirmation in additional studies, however they have identified a number of important implications.

Firstly, our research provides evidence that routine respiratory follow-up of patients hospitalized with COVID-19-pneumonia is required. Secondly, given the length of time it takes for some patients to recover it suggests that research into whether exercise programmes help patients recover more quickly is required. Finally, it highlights the need for treatment strategies to prevent the development of long term COVID-19 related lung changes."

Dr Yihua Wang, Study Co-Lead, Lecturer in Biomedical Sciences, University of Southampton and NIHR Southampton Biomedical Research Centre

Source:

University of Southampton

Journal reference:

Wu, X., et al. (2021) 3-month, 6-month, 9-month, and 12-month respiratory outcomes in patients following COVID-19-related hospitalisation: a prospective study. The Lancet Respiratory Medicine. doi.org/10.1016/S2213-2600(21)00174-0.

Posted in: Medical Research News | Disease/Infection News | Healthcare News

Tags: Blood, CT, Exercise, Hospital, Lungs, Medicine, Oxygen, Pneumonia, Research, Respiratory, Walking

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Bowel cancer: Tenesmus affects digestion and is a major warning sign – what is it?

Dr Hilary Jones discusses bowel cancer awareness acronym

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Bowel cancer is a general term for cancerous cells that multiply uncontrollably in the large bowel (colon and rectum). If it’s detected early enough, treatment can cure bowel cancer and stop it coming back. Unfortunately, because the symptoms of bowel cancer can be subtle and do not necessarily make you feel ill, it is not usually picked up until it has advanced. Experiencing tenesmus is a strong indicator of your risk. What is it?

Medical News Today said: “Rectal tenesmus, or tenesmus, is a feeling of being unable to empty the large bowel of stool, even if there is nothing left to expel.

“Several medical conditions can cause tenesmus.

“These include inflammatory bowel disease (IBD), colorectal cancer, and disorders that affect how muscles move food through the gut.

“It can be painful, especially if there is cramping or other digestive symptoms. The symptoms can come and go, or they may persist long term.

“Vesical tenesmus is a separate condition that relates to the urinary bladder.

“A person will feel as if they are unable to empty the bladder, even when there is no urine present.”

Abdominal pain in colorectal cancer is nonspecific, said the National Library of Health.

The site added: “It can be colicky in nature if the lesion is causing a partial obstruction.

“Otherwise, it can just be constant localized or generalized pain. In the former instance, a localized perforation has to be considered, whereas peritonitis associated with a perforation must be considered in the latter.

“Tenesmus or the feeling of having to defecate without having stools, pain upon defecation, or sciatica can be symptoms of rectal cancer.”

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When a person has tenesmus, they might strain harder to produce only a small amount of stool during bowel movements.

Other conditions which could tenesmus include a colon infection which can be caused by organisms such as a bacteria or virus, ischemic colitis which is an inflammation of the colon due to decreased blood flow to that area, diverticulitis caused by inflammation of the bulges in the wall of the colon, inflammation of the colon due to radiation, the abnormal movement of food or waste in the digestive tract, irritable bowel syndrome, a prolapsed haemorrhoid, rectal abscess or rectal gonorrhoea.

It’s important to speak with your GP about your symptoms as they will be able to determine the cause of your tenesmus.

Other possible causes for tenesmus which include:

  • Colon infection, which can be caused by organisms, such as a bacteria or virus
  • Ischemic colitis, an inflammation of the colon due to decreased blood flow to that area
  • Diverticulitis, caused by inflammation of bulges in the wall of the colon
  • Inflammation of the colon due to radiation
  • The abnormal movement of food or waste in the digestive tract
  • Irritable Bowel Syndrome (IBS)
  • A prolapsed haemorrhoid
  • A rectal abscess
  • Rectal gonorrhoea 

According to Mayo Clinic, treatment for bowel cancer usually involves surgery to remove the cancer.

Other treatments, such as radiation therapy and chemotherapy, might also be recommended.

If your toilet habits have changed recently or you notice any unusual colours or shapes in your stools its imperative to speak with your GP immediately.
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EXPLAINER: Why patents on COVID vaccines are so contentious

The Biden administration’s call to lift patent protections on COVID-19 vaccines to help poor parts of the world get more doses has drawn praise from some countries and health advocates. But it has run into resistance from the pharmaceutical industry and others, who say it won’t help curb the outbreak any time soon and will hurt innovation.

Here’s a look at what patents do and why they matter:

HOW DO DRUG PATENTS WORK?

Patents reward innovation by preventing competitors from simply copying a company’s discovery and launching a rival product. In the U.S., patents on medicines typically last 20 years from when they are filed, which is usually done as soon as a drugmaker thinks it has an important or lucrative drug. Because it often takes a decade to get a drug approved, companies typically end up with about a dozen years of competition-free sales. But drugmakers usually find ways to improve their product or widen its use, and they secure additional patents that can extend their monopoly for another decade or more.

WHY IS PATENT PRODUCTION SO IMPORTANT TO DRUGMAKERS?

Medicines are incredibly expensive to develop. Most experimental drugs fail at some point during what can be years of laboratory, animal and finally human testing. Averaging in the cost of all those flops, it typically costs more than $1 billion to bring a drug from discovery to regulatory approval. Without the prospect of years of sales without competition, that work is all the more risky.

WHY IS THE U.S. BACKING EFFORTS TO LIFT PROTECTIONS ON COVID-19 VACCINES?

The Biden administration has been under intense pressure, including from many Democrats in Congress, to get more COVID-19 vaccines to the rest of the world. Support for the waiver idea floated by India and South Africa in October has been growing in other countries while the outbreak worsens in some places, especially India.

WHY HAVE THE U.S. AND OTHERS OPPOSED LIFTING PROTECTIONS IN THE PAST?

The U.S. and some other wealthy countries lead the world in many areas of research and innovation. That’s particularly true for medicines. Aside from the prestige they confer, pharmaceutical companies provide millions of jobs that pay very well, pay taxes on their income and provide new medicines that can save or improve lives. Drugmakers and their trade groups spend millions every year lobbying governments to maintain the status quo on patents.

WHY IS THE INDUSTRY SO OPPOSED TO THE EFFORT?

In a word, money. In the U.S., pharmaceutical companies can charge whatever they want for their medicines. They can and do raise prices, typically twice a year, so that list prices often double or triple during a drug’s patent-protected years. That makes the big, long-established drugmakers among the world’s most profitable companies. But a huge amount of innovation comes from startup pharmaceutical and biotech companies. They must constantly raise money from venture capital firms and other investors to fund early research until they can get their medicine approved or, more often, get a big drugmaker to help fund the research and buy rights to that drug or the entire startup. Without the prospect of a big payday for the new drug, it would be much harder to attract the crucial early money.

WHAT WOULD BE THE PRACTICAL EFFECTS OF LIFTING PROTECTIONS ON COVID-19 VACCINES?

That’s not entirely clear, but drugmakers and some analysts say waiving their patent rights won’t do much to get COVID-19 vaccines to developing countries faster. That’s because making the vaccines is far more complex than following a recipe, requiring factories with specialized equipment, highly trained workers and stringent quality control — things that can’t be set up quickly. There’s little available factory capacity, as the companies with authorized vaccines already have hired many contract drug manufacturers to help them make their shots. In addition, many of the raw materials to make the vaccines, along with vials, stoppers and other components, are in very short supply, and that’s not expected to change soon.

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Follow Linda A. Johnson at https://twitter.com/LindaJ—onPharma

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Jimmy Kimmel Urges People to Get COVID-19 Vaccine

Editor’s note: Find the latest COVID-19 news and guidance in Medscape’s Coronavirus Resource Center.

On Tuesday’s episode of Jimmy Kimmel Live, host Jimmy Kimmel encouraged people to get a COVID-19 vaccine and featured a video of doctors and nurses across the country who talked about their experiences.

More than 100 million adults in the U.S. are now fully vaccinated, according to the latest CDC tally. Kimmel applauded the number but then pointed out that 26% of adults say they don’t plan to get a vaccine.

“I get that people are skeptical of politicians or celebrities telling them what to do, but we should listen to doctors,” he said. “These are men and women who have been on the front lines of this thing, risking their lives to save ours, and they’re frustrated. Who could blame them?”

In a humorous “public service announcement,” Kimmel asked several health care workers to give advice to those who are on the fence about whether they want to take a vaccine.

“If we don’t get more people vaccinated, we could see new mutations of this virus and go through this all over again,” Kimmel said. “Pay attention, because this is important.”

During the brief video segment, six doctors and nurses spoke about their decades-long work in the medical field. The messaging took on a comedic tone, with the guests pointing out facts about the human body and their experiences delivering babies, performing operations, or looking at their friends’ skin conditions during parties.

They also humorously emphasized the importance of listening to trained medical experts, not rumors on social media sites.

“Your friend from high school, who sells jewelry, she posted it?” a nurse said.

“You heard what on whose podcast?” a doctor said.

“Is he a doctor? No? Scientist? No?” another doctor said.

“Can he name one of the ingredients in the vaccine?” a critical care nurse said.

“And that polio shot we gave your kid, and then your kid not getting polio? Well, those two things are related,” another doctor said.

“How about this? You do your job. I’ll do mine,” a nurse said.

“Get the vaccine,” they all said. “And tell your friend on Facebook to stick to jewelry.”

The Kimmel audience erupted into applause and cheers as the final title card read: “Brought to you by people who are smarter than we are.”

As of Wednesday, the U.S. has shipped more than 321 million COVID-19 vaccines, and 148 million people have received at least one dose, which makes up about 57% of the adult population. More than 41% of adults are considered fully vaccinated, according to the CDC.

Sources

Jimmy Kimmel Live: “Message for People Who Don’t Want the COVID Vaccine.”

CDC: “COVID-19 Vaccinations in the United States.”

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Here’s What You Should Eat And Drink After Getting Your COVID-19 Vaccine

You’ve probably heard stories about how people feel after getting their COVID-19 vaccine, and some of those stories may be extremely off-putting. But there are ways to help prevent unpleasant after-effects from your shot, and that comes from what you eat and drink right after being vaccinated.

Fever, chills, headaches, nausea, and soreness at the injection site have all been reported as side effects of both the Pfizer-BioNTech and the Moderna vaccines. Smithsonian Magazine reported, however, that the percentages of significant side effects are fairly low. In the two-shot process for the Pfizer-BioNTech vaccine, only 3.7% of those vaccinated experienced a fever after the first short, and only 15.8% reported a fever after the second shot. For those 55 years of age or older, the rates are even lower. 

For the Moderna vaccine, less than 1% of people (no matter the age) experienced a fever after the first dose, while 17.4% of younger people and 10.2% of older people felt feverish after the second dose (via Smithsonian). The same side effects have also been reported for the one dose Johnson & Johnson vaccine, according to Medical News Today. But proper nutrition can help alleviate the after-effects for all three approved vaccines in the United States.

Water, water, and more water is essential for post-vaccination health

Hydration is key when getting any vaccine, and that includes the three vaccines approved to combat COVID-19 — Pfizer-BioNTech, Moderna, and Johnson & Johnson. To avoid dehydration, do not drink alcohol prior to getting jabbed or after, Health noted. Alcohol can interfere with your immune system and you want the best immune response possible for this important vaccine.

Of course, one of the best ways to stay hydrated is to drink water. You don’t have to get excessive about it, but do stick to the recommended 64 ounces of water a day both before and after receiving your shot (via Health). You can break down all this water consumption throughout the day in eight 8-ounce glasses, or you can use a refillable water bottle to keep hydrated. Health also noted that it’s perfectly fine to flavor your water with lemon or lime if you just don’t like the taste of plain water. Proper hydration also helps you sleep, which also boosts your immune system.

Fuel your body with healthy foods after your COVID-19 vaccine

Whole foods, rather than processed foods, can help your immune system work correctly and can also assist in warding off vaccine side effects — especially nausea. Shop before your vaccine appointment and have some bland foods on hand like bananas, apple sauce, broth-based soups, brown rice, and potatoes, as noted by Health. All of these foods can both prevent nausea and treat it.

Health also advised that you can eat takeout if you’re not feeling up to cooking soon after being vaccinated, but stick with healthier options instead of ordering fried or fatty fast food. Choose Indian curry, an Asian stir fry, or even veggie tacos (we’re getting hungry just thinking about it).

It’s also possible to lose your appetite after your shot, but you still need to eat. Try to stick to smaller meals and healthy snacks, because your body still needs nutrition no matter what (via Health). The healthier you eat, the healthier you will be, so finally getting vaccinated against COVID-19 might just be the right time to start your journey towards wellness and nutrition.

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Princess Charlotte Has a Teenager Attitude, According to Her Dad

Princess Charlotte turned 6 on May 2, but apparently she likes to tell people she’s 16. And based on that amazing flip-it-back-and-forth hair in her birthday photo and her cheeky attitude, she might be right that her inner teenager is already coming out!

Related story

Meghan Markle Is Dropping a Children’s Book & It’s the Cutest Tribute to Prince Harry & Archie

While her dad Prince William was on an outing on Tuesday, he revealed his daughter will say she’s 16 when asked how old she is, according to reports. Plus, the precocious kid says, “I’m 6 now. I’ll do what I want,” according to her dad.

https://www.instagram.com/p/COWXmaDHnRi/

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While that could be annoyingly snotty coming from some 6-year-olds, we bet that in Charlotte’s adorable-to-Americans British accent and coming out of her sweet face, it would probably just make us LOL and love her even more. Wonder if the little royal’s sauciness comes from mom Kate Middleton‘s side or the Buckingham Palace family?

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Charlotte isn’t the only of the Duke and Duchess of Cambridge’s kids with attitude, apparently. In A Planet For Us All, Prince William’s documentary, he was asked by a curious child if Princess Charlotte was cheekier than Prince George, 7.

“No, they’re about as cheeky as each other,” William answered. “They’re very cheeky.”

No word on the cheeky quotient of the William and Kate’s third child Prince Louis, 3, but we suspect he’s going to follow in his brother and sister’s fresh footsteps!

See the meaning of our favorite royal baby names from around the world.

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