Study links vaccine immune response to age

old people

Older people appear to have fewer antibodies against the novel coronavirus, a new laboratory study from Oregon Health & Science University suggests.

Antibodies are blood proteins that are made by the immune system to protect against infection. They are known to be key players in protection against SARS-CoV-2 infection.

The study published today in the Journal of the American Medical Association.

“Our older populations are potentially more susceptible to the variants even if they are vaccinated,” said senior author Fikadu Tafesse, Ph.D., assistant professor of molecular microbiology and immunology in the OHSU School of Medicine.

Tafesse and colleagues emphasized that even though they measured diminished antibody response in older people, the vaccine still appeared to be effective enough to prevent infection and severe illness in most people of all ages.

“The good news is that our vaccines are really strong,” Tafesse said.

However, with vaccine uptake slowing in Oregon and across United States, researchers say their findings underscore the importance of promoting vaccinations in local communities.

Vaccinations reduce the spread of the virus and new and potentially more transmissible variants, especially for older people who appear to be more susceptible to breakthrough infections.

“The more people get vaccinated, the less the virus circulates,” Tafesse said. “Older people aren’t entirely safe just because they’re vaccinated; the people around them really need to be vaccinated as well. At the end of the day, this study really means that everybody needs to be vaccinated to protect the community.”

Researchers measured the immune response in the blood of 50 people two weeks after their second dose of the Pfizer vaccine against COVID-19. They grouped participants into age groups and then exposed their blood serum in test tubes to the original “wild-type” SARS-CoV-2 virus and the P.1 variant (also known as gamma) that originated in Brazil.

The youngest group—all in their 20s—had a nearly seven-fold increase in antibody response compared with the oldest group of people between 70 and 82 years of age. In fact, the laboratory results reflected a clear linear progression from youngest to oldest: The younger a participant, the more robust the antibody response.

“Older people might be more susceptible to variants than younger individuals,” Tafesse said.

The findings highlight the importance of vaccinating older people as well as others who may be more vulnerable to COVID-19, said co-author Marcel Curlin, M.D., associate professor of medicine (infectious diseases) in the OHSU School of Medicine.

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J&J and AZ study if modifying vaccines can reduce risk of blood clots

Johnson & Johnson and AstraZeneca are studying whether modifying their COVID-19 vaccines can reduce or eliminate the risk of rare blood clots

  • Johnson & Johnson and AstraZeneca-University of Oxford have begun studying whether their COVID-19 vaccines can be modified
  • Both shots have been linked to a risk of blood clots along with a low platelet-count condition known as thrombocytopenia
  • Scientists hope to identify the causes behind the blood clots and maybe re-engineer the shots by next year
  • In the U.S., J&J’s vaccine has been linked to 0.3 cases of rare blood clots per 100,000 doses and AstraZeneca’s jab linked to 1-2 cases per 100,000
  • It comes one day after it was revealed the FDA is adding a new warning to the label of J&J’s vaccine due the risk of a rare autoimmune disorder

Johnson & Johnson, AstraZeneca and the University of Oxford have begun studying whether or not modifying their COVID-19 vaccines can reduce or eliminate the risk of rare, deadly blood clots.

First reported by The Wall Street Journal, sources say scientists are working to  identify the causes behind the blood clots and potentially re-engineer the shots to be distributed by next year.

Both the J&J and AstraZeneca vaccines have been linked to clots along with a low platelet-count condition known as thrombocytopenia, which researchers have dubbed vaccine-induced immune thrombotic thrombocytopenia (VITT).       

A J&J spokesman told The Journal that the New Jersey-based company supports ‘continued research and analysis as we work with medical experts and global health authorities’ but did not answer specific questions about the early-stage research.

An AstraZeneca spokesperson elaborated and said the firm is ‘actively working with the regulators and scientific community to understand these extremely rare blood-clotting events, including information to drive early diagnosis and intervention, and appropriate treatment.’

Although it’s unknown if the vaccines can even be modified, it might lead to changes in either ownership rights or approval by regulators, the newspaper reported.

The news comes just one day after it was revealed that the U.S. Food and Drug Administration (FDA) is adding a new warning to the label of J&J’s vaccine due the risk of a rare autoimmune disorder. 


Johnson & Johnson (left) AstraZeneca and the University of Oxford (right) have begun studying whether their COVID-19 vaccines can be modified to lower the risk of blood clots along with a low platelet-count condition known as thrombocytopenia

Scientists hope to identify the causes behind the blood clots and maybe re-engineer the shots by next year

Both AstraZeneca’s and J&J’s immunization are known as viral vector vaccines.

They combine genetic material from the new virus with the genes of the adenovirus -which causes the common cold – to induce an immune response. 

The shots were deemed game-changers because they do not need to be stored at freezing temperatures like the Pfizer-BioNTech and Moderna vaccines.

What’s more, because J&J’s vaccine only requires one shot, it was expected to be used to inoculate hard-to-serve populations such as people living in rural areas and homebound seniors.

Being able to modify their vaccines to eliminate the risk of blood clots could increase confidence in the jabs. 

In April. the J&J vaccine was paused by the Centers for Disease Control and Prevention (CDC) and FDA for 10 days after six women under the age of 50 developed Cerebral Venous Sinus Thrombosis (CVST), a rare blood clot that forms in the venous sinuses in the brain.

The women developed CVST in combination with thrombocytopenia. 

This figure was later updated to include 28 people, including one 45-year-old woman who died. 

The pause was lifted and the FDA added a warning to J&J’s coronavirus vaccine that rare blood clotting events might occur, primarily among women under age 50.

Data from the CDC suggest the rate of clotting is about 0.3 cases per 100,000 doses of the J&J vaccine. 

Meanwhile, in April, the European Medicine Agency’s safety committee determined that blood clots with low blood platelets should be listed as very rare side effect of the AstraZeneca-Oxford vaccine.

According to data from the UK and Europe, the rate of blood clotting with the AstraZeneca vaccine is slightly higher at about one or two per 100,000 doses. 

Several countries, including the UK, have recommended that people under age 60 be immunized with other vaccines because their risk of blood clotting is greater.

Earlier this year, German researchers at Goethe-University of Frankfurt and Ulm University, in Helmholtz, believe the the problem lies in the adenovirus vector, the common cold virus used so both vaccines can enter the body. 

They believe that in some people, the immune system sees the vaccine as a threat and over-produces antibodies to fight it. 

These lead to the formation of clumps in the blood, which can become deadly if the clots move towards vital organs and cut off supply. 

‘Progress is being rapidly pursued by the companies, and I think their desire to alter the vector or the vaccine is moving in parallel to explaining [the clots],’ Dr Mortimer Poncz, chief of the pediatric-hematology division at Children’s Hospital of Philadelphia told The Journal.

Recently both J&J’s and AstraZeneca’a vaccine were linked to Guillain-Barré syndrome, a rare autoimmune condition in which the immune system attacks the peripheral nervous system, temporarily paralyzing parts of the body.   

On Monday, The Washington Post reported that the FDA is add a warning to the J&J label about the condition.

The CDC said it has received about 100 preliminary reports of Guillain-Barré following the one-dose vaccine   

Most the cases have occurred about two weeks after vaccination and mostly in men aged 50 and older – and that this has not been seen with either the Pfizer-BioNTech or Moderna vaccines.

And a report from the American Neurological Association in June detailed 11 cases of patients who developed Guillain-Barré after receiving the AstraZeneca vaccine. 

Q&A: ALL YOU NEED TO KNOW ABOUT COVID VACCINES AND THEIR TINY RISK OF BLOOD CLOTS

IS THERE ANY PROOF THE JAB CAUSES THE BLOOD CLOTS?

Scientists have repeatedly insisted there is no proof yet that coronavirus vaccines cause the extremely rare complication — blood clots occurring alongside low platelet levels.

But officials are still investigating the link — found in recipients of both AstraZeneca and Johnson and Johnson’s vaccines — and can’t rule it out completely. 

DO SCIENTISTS HAVE A THEORY FOR WHAT MAY BE THE LINK?  

Experts are stumped as to why the vaccines may be triggering blockages in very rare cases.

But researchers in Germany believe the problem lies in the adenovirus vector — a common cold virus used so both vaccines can enter the body.

Academics investigating the issue say the complication is ‘completely absent’ in mRNA vaccines like Pfizer’s and Moderna’s because they have a different delivery mechanism.

Experts at Goethe-University of Frankfurt and Ulm University, in Helmholtz, say the AstraZeneca vaccine enters the nucleus of the cell – a blob of DNA in the middle. For comparison, the Pfizer jab enters the fluid around it that acts as a protein factory.

Bits of coronavirus proteins that get inside the nucleus can break up and the unusual fragments then get expelled out into the bloodstream, where they can trigger clotting in a tiny number of people, scientists claim.

WHAT SYMPTOMS DO THEY CAUSE?

The EMA said symptoms can strike up to three weeks post-vaccination.

British regulators say the complication tends to occur four days after people first get jabbed. 

Symptoms of the two blood clots can include: 

  • Shortness of breath
  • Chest pain
  • Swollen legs
  • Persistent stomach pain
  • Severe or persistent headache
  • Blurred vision
  • Confusion
  • Seizures 
  • Skin bruising beyond the site of injection

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Study concludes that U.S. COVID vaccine rollout saved 279,000 lives

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(HealthDay)—COVID-19 vaccines have prevented at least 279,000 deaths and 1.25 million hospitalizations in the United States, but the Delta variant poses a significant threat to that progress, researchers say.

“The vaccines have been strikingly successful in reducing the spread of the virus and saving hundreds of thousands of lives in the United States alone,” said study author Alison Galvani, director of the Center for Infectious Disease Modeling and Analysis at the Yale School of Public Health.

“Yet until a greater majority of Americans are vaccinated, many more people could still die from this virus,” she said in a Yale news release. “The danger is not over. Now is not the time to let down our guard.”

Galvani and her team analyzed data from Oct. 1, 2020 through July 1 and found that more than 328 million COVID-19 vaccine doses were given during that time, and that 67% of adults received at least one dose.

If only half as many shots had been administered there would have been more than 120,000 additional deaths and 450,000 additional hospitalizations, according to the researchers.

It also found that the number of COVID-19 cases plummeted from more than 300,000 a day at the pandemic’s peak in January to less than 20,000 a day in mid-June.

However, the progress made with the national vaccination program could be quickly reversed by the highly transmissible Delta variant if it triggers a spike of new cases among the millions of people who haven’t been vaccinated, the researchers warned.

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Study finds time-restricted eating may reduce diabetes-related hypertension

hypertension

A new University of Kentucky College of Medicine study suggests that time-restricted eating may be able to help people with Type 2 diabetes reduce nocturnal hypertension, which is characterized by elevated blood pressure at night.

The study published in PNAS June 22 found that time-restricted eating, a routine in which eating is restricted to a specific window of time during each day, helped prevent and improve diabetes-related nocturnal hypertension in mice.

Study authors Ming Gong, Ph.D., M.D., professor in the Department of Physiology, and Zhenheng Guo, Ph.D., professor in the Department of Pharmacology and Nutritional Sciences, are hopeful their findings will mean time-restricted eating could offer similar benefits for people.

“We are excited about these findings and the implications they could have in future clinical studies,” said Guo. “In addition to lifestyle changes like diet and exercise, time-restricted eating could have a healthy impact on people with Type 2 diabetes.”

Normally, blood pressure falls at night and increases upon awakening, in line with the body’s circadian rhythm. In some hypertensive patients, the typical nighttime decrease does not occur. This “nondipping” blood pressure is prevalent in patients with Type 2 diabetes and is associated with increased events of cardiovascular disease.

The study found that imposing time-restricted feeding prevented diabetic mice from developing nondipping blood pressure. The practice also effectively restored the disrupted blood pressure circadian rhythm in mice that already had nondipping blood pressure.

Researchers restricted the mice’s access to food to eight hours during their typical active awake times every day. When food availability was increased to 12 hours, the practice was still effective in preventing and treating nondipping blood pressure. Guo says this is evidence that the effects were caused by the timing of feeding and not calorie restriction.

In addition to the study’s significance for future clinical research in people, Gong says it’s adding to scientists’ understanding of the causes and mechanisms of nondipping blood pressure in diabetes, which is currently not fully understood.

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Study identifies biomarker that could help to diagnose pancreatic cancer

Pancreatic cancer

Researchers from Queen Mary University of London have identified a protein that could be used to aid in the diagnosis of pancreatic cancer.

Findings from the new study suggest that a protein called pentraxin 3 (PTX3) may be a specific diagnostic biomarker—or biological measure—for pancreatic cancer, with the ability to differentiate pancreatic cancer from other non-cancerous conditions of the pancreas.

The research was published today in npj Precision Oncology, and primarily funded by the Pancreatic Cancer Research Fund, Barts Charity and Cancer Research UK.

PTX3 levels elevated in patients with pancreatic cancer

In the study, researchers measured PTX3 levels in serum blood samples from patients with pancreatic ductal adenocarcinoma (PDAC) – the most common type of pancreatic cancer—and from healthy volunteers or patients with other non-cancerous conditions of the pancreas, and found levels of the protein to be significantly higher in the serum samples of those with PDAC.

Patients with PDAC had notably higher serum PTX3 levels than those with intra-ductal papillary mucinous neoplasm or chronic pancreatitis—two non-cancerous conditions that often present with similar symptoms to PDAC, making a definitive diagnosis more difficult.

Hemant Kocher, Professor of Liver and Pancreas surgery at Queen Mary University of London and consultant at Barts Health NHS Trust, who led the study, said: “In the clinic, computerised tomography (CT) scanning is usually used in the diagnosis of pancreatic cancer. Although CT can detect the presence of a pancreatic mass, it cannot distinguish pancreatic cancer from other non-cancerous pancreatic diseases. This poses frequent diagnostic dilemmas in clinical practice, and there are currently no clinically applicable biomarkers for the early detection of PDAC.”

“The findings from our study suggest that PTX3 could be used as a biomarker to improve PDAC diagnosis, and warrants further testing to determine whether it could aid early detection of PDAC in the clinic.”

“Thanks to the generous donation of samples from patients in London, Verona and Milan, our study represents a clinically relevant cohort with translational significance. This research has been made possible by an international collaboration of cancer biologists, surgeons, oncologists, clinical triallists, statisticians and bio-banking specialists, with funding from a number of sources.”

Blood samples from 267 donors were analysed, including 140 samples from patients with PDAC, which had been donated to tissue banks in London, Verona and Milan. Samples in London were from the Pancreatic Cancer Research Fund Tissue Bank—the national tissue bank for pancreatic cancer.

The research was performed in collaboration with researchers from Humanitas Research Hospital and Humanitas University (Milan, Italy), including Dr. Paola Allavena and Professor Alberto Mantovani (who also holds the Chair of Inflammation and Therapeutic Innovation at Queen Mary’s William Harvey Research Institute), and ARC-NET Research Centre for Applied Research on Cancer (Verona, Italy), including Dr. Aldo Scarpa. The Humanitas team is supported by the Italian Association for Cancer Research (AIRC).

A cancer biomarker released from non-cancerous cells

Most cancer biomarkers used in clinical practice are proteins released from the cancer cells themselves. One of the defining features of PDAC is that there are very few cancer cells; pancreatic cancer is surprisingly made up of mostly non-cancer cells, which have been co-opted by cancer to build a huge amount of scar tissue or stroma around the cancer, providing a strong defence for the cancer cells.

The unique feature of PTX3 is that this biomarker is released from non-cancerous cells such as stellate cells (star shaped cells) that surround the pancreatic tumour. Further analyses conducted by the team in human PDAC samples, pancreatic cancer cell lines and a mouse model of pancreatic cancer confirmed that PTX3 is, indeed, released predominantly from pancreatic stellate cells when they have been activated in response to signals from cancer cells.

By looking at data from clinical trials, the team found that when pancreatic cancer alone is targeted, PTX3 does not seem to change upon administration of chemotherapy; however, when medications targeting both cancer and stroma are administered, changes are seen in PTX3 levels. This change in PTX3 can be easily measured in blood to monitor how the drug is working. Thus, PTX3 may help in monitoring the effectiveness of treatment much earlier than scans may be able to indicate treatment response.

Stellate cells have an important role in normal tissue formation, and normal stellate cells do not seem to release PTX3. Stellate cells release PTX3 when they are ‘activated,’ which can occur in cancer or in response to other conditions. Therefore, further investigations are necessary to determine whether the PTX3 levels detected in this study are specific to stellate cell activation in PDAC.

Direction for future clinical trials

Pancreatic cancer is the deadliest of the common cancers and claims the lives of approximately 9,400 people each year in the UK. The majority of pancreatic cancer cases are diagnosed when the cancer is at an advanced stage due to a lack of specific symptoms at the early stages of the disease and the absence of specific biomarkers that can aid early detection.

This study suggests that PTX3 may be a sensitive and specific biomarker able to distinguish cancerous from non-cancerous conditions of the pancreas. The team hope the findings will provide direction for future prospective clinical trials to determine whether PTX3 could be effective in the clinic as a biomarker for early detection and, perhaps, used in conjunction with other biomarkers to monitor response to treatment of pancreatic cancer.

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Dutch study finds antibiotic-resistant bacteria common in veterinary staff

veterinary

New research being presented at the European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) held online this year (9-12 July), suggests that one in 10 veterinary workers in the Netherlands carries strains of extended spectrum beta-lactamase (ESBL)-producing bacteria compared to around one in 20 of the general Dutch population.

This higher prevalence could not be explained by known risk factors such as antibiotic use or recent travel, and it seems highly likely that occupational contact with animals in the animal healthcare setting may result in shedding and transmission of multi-drug resistant pathogens, researchers say.

Escherichia coli (E. coli) and Klebsiella pneumoniae bacteria are common in the intestines of healthy people and animals. There are a number of different types and, while the majority are harmless, some can cause serious food poisoning and life-threatening infections, including blood poisoning, with over 40,000 cases each year in England alone. Particularly important are infections caused by highly resistant strains with ESBL and AmpC-producing Enterobacteriaceae (AmpC-E), which are resistant to multiple antibiotics including penicillin and cephalosporins, and have become a matter of great concern in both human and animals.

Understanding the extent of transmission from animals to humans is key to developing effective prevention strategies.

In this study, scientists from the National Institute for Public Health and the Environment in the Netherlands wanted to find out how these resistant bacteria are spread and investigated whether there is a cross-over from occupational contact with different types of livestock and companion animals (ie, cats and dogs) to humans.

Stool samples were collected from 482 veterinary workers (including vets, technicians and assistants), and genetic sequencing was used to identify both the species of bacteria in each sample, and the presence of ESBL and AmpC drug resistance genes. Veterinary staff also completed questionnaires about their contact with animals at work and at home, health status, travel behaviour and hygiene, which were analysed to determine additional risk factors.

The analysis found that almost 1 in 10 (9.8%, 47/482) veterinary workers were colonised with at least one ESBL/AmpC-producing bacterial strain (see table in full abstract, link below).

The most commonly occurring ESBL resistance genes were blaCTX-M-15 (26 samples), blaCTX-M-14 (7) and blaDHA-1 (4). The most common E. coli strain identified in the participants was ST131 (9 samples); a frequent cause of serious bladder infections in humans.

Further analyses of risk factors found that veterinary workers who had travelled to Africa, Asia or Latin America in the past six months were four times more likely to carry bacteria with ESBL resistance genes, while those reporting stomach/bowel problems in the past four weeks were twice as likely to be colonised with these resistant bacteria.

Importantly, almost half (48.5%, 16/33) of veterinary staff who tested positive for these resistant bacteria, did so again six months later. And in 14 participants the same ESBL gene and E. coli strain was found. In addition, the findings reveal that four of 23 (17%) of their household members carried ESBL-producing bacteria, and in three of those this was the same ESBL gene and E. coli strain found in the veterinary worker.

“Around 10% of veterinary staff were positive for these resistant bacteria—double the prevalence in the Dutch population (4.5%)”, says lead author Anouk Meijs from the National Institute for Public Health and the Environment in the Netherlands. “This higher prevalence could not be explained by known risk factors such as antibiotic use and travel. So it seems highly likely that occupational contact with animals in the animal healthcare setting can provide a reservoir for ESBL-producing bacteria, despite the absence of specific occupational risk factors, such as contact with specific animal species. In order to tackle antibiotic resistance, we not only need to drive down inappropriate prescribing, but reduce transmission in the first place with strict hygiene standards.”

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Study links COVID-19 public health efforts to dramatic drop in COPD hospitalizations

covid

Researchers at the University of Maryland School of Medicine (UMSOM) analyzed data at the 13-hospital University of Maryland Medical System (UMMS) and found public health measures designed to reduce the spread of the COVID-19 virus may have fostered a substantial side benefit: Hospital admissions for chronic obstructive pulmonary disease (COPD) were reduced by 53 percent, according to a new study published in The American Journal of Medicine. This is likely due to a drop in circulating seasonal respiratory viruses such as influenza.

Hospitalizations for COPD, a group of lung diseases that make it hard to breathe and get worse over time, are commonly driven by flare-ups where symptoms are triggered by such factors as tobacco smoke, air pollution and respiratory infections. Seasonal respiratory viruses, including those that cause the common cold or influenza, trigger nearly half of those flare-ups.

In the wake of a marked drop in COPD admissions during the pandemic, the researchers theorized that COVID-19 behavior changes—a mix of stay-at-home orders, social distancing, masking mandates and strict limitations on large gatherings—not only protected against COVID-19, but they may have also reduced exposure to other respiratory infections.

Conversely, they worry that the return to normal behavior may lead to more COPD flare-ups.

“Our study shows there’s a silver lining to the behavior changes beyond protecting against COVID-19,” said senior author Robert M. Reed, MD, UMSOM Professor of Medicine and pulmonologist at the University of Maryland Medical Center (UMMC). “If we completely eliminate masks and distancing during cold and flu season, we’ll allow all those viruses that have been effectively suppressed to come raging back. There could be a lot of illness.”

Prior to the COVID-19 pandemic, COPD was the fourth-leading cause of death worldwide and a leading cause of hospital admissions in the United States. The pandemic has led to significant changes in health care delivery, including reduced admissions for COPD and other non-COVID illnesses, some of which may have stemmed from patients’ fear of contracting COVID in various hospital settings, as well as a shift toward telemedicine and outpatient COPD management during the pandemic.

To understand what may have occurred to reduce COPD admissions, the researchers compared weekly hospital admissions for COPD in the pre-COVID-19 years of 2018 and 2019, with admissions after the COVID-19 public health measures were instituted. At UMMS, those measures were implemented before April 1, 2020, so the investigators chose the same five-month period in each year for their comparison, April 1 to Sept. 30.

Co-lead author Jennifer Y. So, MD, UMSOM Assistant Professor of Medicine and COPD specialist at UMMC, said electronic medical records from multiple hospitals across a range of communities in the UMMS database facilitated a granular evaluation of changes over time. “We assessed a variety of possible causes that could affect COPD admissions including the presence of multiple diseases or medical conditions and the frequency of COPD exacerbations.”

The database findings were correlated with data on respiratory viral trends from the U.S. Centers for Disease Control and Prevention for the period of Jan. 1, 2018, through Oct. 1, 2020.

“We found a 53 percent drop in COPD admissions throughout UMMS during COVID-19. That is substantial, but equally significant, the drop in weekly COPD admissions was 36 percent lower than the declines seen in other serious medical conditions, including congestive heart failure, diabetes and heart attack,” said Dr. So.

As more and more people are vaccinated against COVID-19 and many of the public health measures of the past year are relaxed, the researchers warn that a full return to normal may again expose COPD patients to the familiar seasonal triggers.

“Our study did not assess which public health components worked to tame seasonal respiratory viruses, but a simple thing like wearing a mask while riding on public transit or working from home when you’re sick with a cold could go a long way to reduce virus exposure,” said Dr. Reed.

Dr. So, who is from South Korea, said it is a cultural norm to wear masks during the winter in her native country. “The COVID-19 pandemic has helped a lot of people around the world become more aware of the role of masking and social distancing to reduce the spread of disease,” she said.

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Study shows obesity may increase risk of long-term complications of COVID-19

obese

A Cleveland Clinic study shows that survivors of COVID-19 who have moderate or severe obesity may have a greater risk of experiencing long-term consequences of the disease, compared with patients who do not have obesity. The study was recently published online in the journal of Diabetes, Obesity and Metabolism.

Multiple studies have identified obesity as a risk factor for developing a severe form of COVID-19 that may require hospital admission, intensive care, and ventilator support in the early phase of the disease. Obesity, which is a complex disease caused by multiple factors, is associated with an increased risk for cardiovascular disease, blood clots and lung conditions. In addition, obesity weakens the immune system and creates a chronic inflammatory state. Those conditions can lead to poor outcomes after an infection with SARS-CoV-2, which is the virus that causes COVID-19.

“To our knowledge, this current study for the first time suggests that patients with moderate to severe obesity are at a greater risk of developing long-term complications of COVID-19 beyond the acute phase,” said Ali Aminian, M.D., director of Cleveland Clinic’s Bariatric & Metabolic Institute and principal investigator of the research.

In this observational study, researchers used a registry of patients who tested positive for SARS-CoV-2 infection within the Cleveland Clinic health system in a five-month period from March 2020 to July 2020, with follow-up until January 2021.

Researchers examined three indicators of possible long-term complications of COVID-19—hospital admission, mortality, and need for diagnostic medical tests—that occurred 30 days or later following the first positive viral test for SARS-CoV-2. The outcomes were compared among five groups of patients based on their body mass index (BMI): 18.5-24.9 (normal), 25-29.9 (overweight), 30-34.9 (mild obesity), 35-39.9 (moderate obesity), and 40 or greater (severe obesity). Obesity is a disease classified as having a BMI of 30 or greater.

A total of 2,839 patients who did not require ICU admission and survived the acute phase of COVID-19 were included in the final results of this study. The normal BMI group was considered as a reference.

The study found that a health condition called post-acute sequelae of SARS-CoV-2 infection (PASC) is an extremely common problem in COVID-19 survivors. Specifically, during a 10-month follow-up after the acute phase of COVID-19, 44% of the study participants had required hospital admission and 1% died. Furthermore, results show that compared with patients with normal BMI, the risk of hospital admission was 28% and 30% higher in patients with moderate and severe obesity, respectively. The need for diagnostic tests to assess different medical problems, compared with patients with normal BMI, was 25% and 39% higher in patients with moderate and severe obesity, respectively.

More specifically, the need for diagnostic tests to assess cardiac, pulmonary, vascular, renal, gastrointestinal, and mental health problems was significantly higher in patients with a BMI of 35 or greater, compared with normal BMI patients.

“The observations of this study can possibly be explained by the underlying mechanisms at work in patients who have obesity, such as hyper-inflammation, immune dysfunction, and comorbidities,” said Bartolome Burguera, M.D, Ph.D., chair of Cleveland Clinic’s Endocrinology & Metabolism Institute and co-investigator of the study. “Those conditions can lead to poor outcomes in the acute phase of COVID-19 in patients with obesity and could possibly lead to an increased risk of long-term complications of COVID-19 in this patient population.”

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Study evaluates the filtration efficacy of 227 commercially available face masks in Brazil

Study evaluates the filtration efficacy of 227 commercially available face masks in Brazil

The novel coronavirus is transmitted mainly via inhalation of saliva droplets or respiratory secretions suspended in air, so that face covering and social distancing are the most effective ways to prevent COVID-19 until enough vaccines are available for all. In Brazil, fabric masks are among the most widely used because they are cheap, reusable and available in several colors or designs. However, this type of face covering’s capacity to filter aerosol particles of a size equivalent to the novel coronavirus can vary between 15% and 70%, according to a study conducted in Brazil by the University of São Paulo (USP).

The study was supported by FAPESP, and the principal investigator was Paulo Artaxo, a professor in the university’s Physics Institute (IF-USP). It was part of an initiative called (respire! to assure access to safe masks for the university community. The results are reported in an article in the journal Aerosol Science and Technology.

“We appraised the filtration efficacy of 227 models sold by drugstores and other common types of store in Brazil to see how much genuine protection they afford the general public,” Artaxo told Agência FAPESP.

The scientists conducted a test using a device that contained a sodium chloride solution and emitted aerosol particles of 100 nanometers. SARS-CoV-2 is about 120 nanometers in diameter. A burst of aerosols was triggered, and particle concentration was measured before and after the mask.

As expected, surgical masks were most effective in the test, as were the FFP2 or N95 models certified for professional use, filtering 90%-98% of the particles. Next came masks made of non-woven fabric (TNT) or polypropylene and sold in many kinds of store, with an efficiency of 80%-90%, followed by those made of ordinary cotton, spandex or microfiber, which filtered 40% on average (15%-70%). 

Several factors were critical in enhancing or reducing the degree of protection. “Generally speaking, masks with a central seam protect less because the sewing machine makes holes that increase the passage of air. A tightly fitting top edge improves filtration significantly. Some masks made of fabric include fibers of nickel, copper or other metals that inactivate the virus and hence protect the wearer more effectively. There are even electrically charged models that retain more particles. In all cases, however, efficacy drops when the mask is washed because of wear and tear,” said Fernando Morais, first author of the article. Morais is a Ph.D. candidate at IF-USP and a researcher at the Nuclear and Energy Research Institute (IPEN), an agency of the São Paulo State Government. 

Breathability

According to Artaxo, dual-layer cotton masks filtered considerably better than single-layer models, but efficacy was hardly altered by a third layer, which reduced breathability.

“The study innovated in several ways. One was its evaluation of breathability or resistance to air passage,” Artaxo said. “TNT and cotton masks were best in this regard. The FFP2 and N95 models were not as comfortable, but paper masks were the worst. This is important because if a person can’t bear wearing a mask even for five minutes, it’s useless.”

The authors of the article note that although mask efficacy varies, all types help reduce transmission of the virus, and mask-wearing in conjunction with social distancing is fundamental to control the pandemic. They advocate mass production of FFP2/N95 masks for distribution free of charge to the general public. This “should be considered in future pandemics,” according to Vanderley John, penultimate author and coordinator of (respire!, which is organized by USP’s Innovation Agency.

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Study shows racial differences in personal care product use, may lead to health inequities

hair products

A large survey of women in California shows significant racial and ethnic differences in the types of personal care products women use on a daily basis. Because many personal care products contain endocrine disrupting chemicals (EDCs) like parabens and phthalates that interfere with the body’s hormones, the findings could shed light on how different products influence women’s exposures to harmful chemicals that contribute to health inequities.

The study appears in the Journal of Exposure Science & Environmental Epidemiology as part of a special issue focused on health equity.

“We know Black women have higher levels of many EDCs in their bodies than other groups of women,” says lead author Dr. Robin Dodson, an environmental exposure scientist at Silent Spring Institute. “What we don’t know is what’s driving these exposures, and therefore what’s driving some of the health disparities we see in the U.S. population.”

The new study aims to fill that gap by providing one of the first comprehensive inventories of the range and types of products women use across race and ethnicity.

Black women go through puberty at younger ages, and have higher rates of hormone-mediated problems such as pre-term birth, uterine fibroids, and infertility than other groups of women. Incidence rates of breast cancer and endometrial cancer among Black women are also increasing.

Given evidence linking exposure to EDCs with harmful health effects such as reproductive problems and cancer, and the lack of data on the kinds of products women of color use, researchers decided to partner with community groups in California to survey a diverse group of women.

The survey is part of a larger effort called the Taking Stock Study—a collaboration between Occidental College, Black Women for Wellness, LA Grit Media, Silent Spring Institute, and George Washington University Milken Institute School of Public Health.

The team surveyed 357 women living in California about their use of personal care products, focusing on women of reproductive age, between the ages of 18 and 34. Participants were asked about the types of products they use, how often they use them, and why they choose certain ones over others.

The researchers gathered information on 54 types of personal care products, including cosmetics, hair products, menstrual or intimate products such as douches, and body lotions. The team also asked about the use of scented products.

Women in the study reported using on average eight products a day, with some using up to 30 products daily. When researchers compared product use among Black, Hispanic/Latinx, Asian, and White women, they noted a number of differences:

  • For 28 of the products, use varied significantly by race/ethnicity, with the largest differences seen between Black and White women.
  • Hispanic/Latinx and Asian women reported using more cosmetics than Black and White women.
  • Black women reported using a higher number of hair products and more menstrual/intimate products.

The use of scented products was also common, with 70 percent of women preferring scented over unscented options. Scientists are concerned about exposure to fragrance ingredients in products because they often consist of dozens of undisclosed and unregulated chemicals, some of which have been linked with asthma and hormone disruption.

Dr. Bhavna Shamasunder, an environmental health researcher at Occidental College who is co-leading the Taking Stock Study, says racism may underlie these patterns. “Women of color can feel pressure to conform to European beauty norms, whether from workplaces or widespread media images. But to achieve straighter hair or a different skin tone through use of a product, you have to use pretty toxic chemicals.”

“This study is important not only because it shows how women of color and Black women in particular are more highly exposed to dangerous chemicals, but it also reinforces the notion that racism is a public health issue,” says Janette Robinson Flint, executive director of Black Women for Wellness.

Next, the team plans to collect urine samples from study participants to measure levels of EDCs in their bodies and compare their levels with the products they use. The researchers also plan on testing products for a range of chemicals to find out which products pose a greater risk.

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