Covid raises risk of stillbirth, new research finds. What to know about vaccines during pregnancy

‘In September, the US Centers for Disease Control and Prevention recommended "urgent action" be taken to get pregnant people, and those who want to be pregnant in the future, vaccinated against COVID-19. The alert was issued after mounting evidence demonstrated how COVID-19 affected the outcomes of pregnancy and the overall health of the pregnant person. As of mid-September, only 31% of pregnant people were vaccinated against COVID-19 -- a much lower rate than the general US adult population -- but they had a 70% increased risk of dying from symptomatic COVID-19 compared to people who weren't pregnant. 

‘Now, research is showing that pregnant people with COVID-19 have a higher risk of their baby being stillborn, according to a November report by the CDC. While the overall rate of stillbirths was low from March 2020 to September 2021, people who had COVID-19 during their delivery had a 1.26% chance of stillbirth, compared to people without COVID-19 at .64% -- roughly double the risk. This risk was even higher, the CDC said, during the months the delta variant was circulating.’

Read here (CNET, Nov 23, 2021)

Risk of stillbirth has risen for women with Covid-19, CDC study shows

‘Pregnant women who tested positive for Covid-19 when admitted to a hospital to give birth were at a greater risk for stillbirth compared to those who did not, according to a study released by the U.S. Centers for Disease Control on Friday, with risks rising more since the delta variant has become the dominant strain.’

Read here (Forbes, Nov 19, 2021)

Read CDC report here.

Covid-19 increases the chance of getting an autoimmune condition. Here’s what the science says so far

‘SARS-CoV-2, the virus that causes COVID-19, can sometimes cause the immune system to mistakenly attack the person’s own body. This process, known as “autoimmunity”, can damage a number of different organs... The science on how and how often this occurs is still emerging. But here’s what we know so far...

This article attempts to answer the following:

• How do viruses trigger autoimmunity?
• What autoimmune conditions can COVID-19 trigger?
• What’s causing the damage?
• Could vaccination help?
• What’s next for research in this area?

Read here (The Conversation, Sept 23, 2021)

More risks to pregnant women, their newborns from COVID-19 than known before - Study

‘Pregnant women infected with COVID-19 and their newborn children face higher risks of complications than was previously known, a study by British scientists showed on Friday. An infection of the new coronavirus in such newborns is associated with a three-fold risk of severe medical complications, according to a study conducted by scientists at the University of Oxford. (https://bit.ly/3tNwkJ7)

‘Pregnant women are at higher risk of complications such as premature birth, high blood pressure with organ failure risk, need for intensive care and possible death. "Women with COVID-19 during pregnancy were over 50% more likely to experience pregnancy complications compared to pregnant women unaffected by COVID-19," said Aris Papageorghiou, co-lead of the trial and a professor of fetal medicine at Oxford University.’

Read here (Reuters, Apr 23, 2021)

A third of Covid survivors suffer neurological or mental disorders: Study

‘One in three COVID-19 survivors in a study of more than 230,000 mostly American patients were diagnosed with a brain or psychiatric disorder within six months, suggesting the pandemic could lead to a wave of mental and neurological problems, scientists said.

‘Researchers who conducted the analysis said it was not clear how the virus was linked to psychiatric conditions such as anxiety and depression, but that these were the most common diagnoses among the 14 disorders they looked at.

‘Post-COVID cases of stroke, dementia and other neurological disorders were rarer, the researchers said, but were still significant, especially in those who had severe COVID-19.’

Read here (Reuters, Apr 7, 2021)

Covid-19 & neurological conditions

‘A study published in The Lancet Psychiatry estimates that more than one-third of COVID-19 survivors experienced neurological symptoms within 6 months of their infection. Researchers at the University of Oxford (UK) evaluated medical record data for nearly 250,000 COVID-19 patients and found that 33.62% were diagnosed with a neurological or psychiatric condition in the 6 months following their infection, including 12.84% for whom this was their first such diagnosis. The proportion increased among those who were admitted to an intensive care/treatment unit (ICU/ITU), up to 46.42% and 25.79%, respectively. The most common conditions included anxiety disorders (17.39%), mood disorders (13.66%), substance use disorder (6.58%), insomnia (5.42%), nerve disorders (2.85%), and ischemic stroke (2.10%). The study breaks down each condition by disease severity.’

Read here (The Lancet, April 6, 2021)

Read press release here

Covid-19 is different now: Our response to Covid-21 cannot be myopic

‘We are at an inflection point that will change the reality of this disease. The most insidious future is one in which we fail to change our moral benchmarks, and end up measuring the danger of COVID-21 by the standards of 2020. If wealthy countries with early access to vaccines abandon continued, global coronavirus-vaccination efforts as their cases fall or when the disease becomes milder for them, a still-severe disease could haunt the world indefinitely—and lead to rebounds everywhere.

‘Avoiding this myopia is the central challenge of COVID-21. It extends to the systemic problems highlighted by this pandemic. Much of the damage the virus has wrought has come indirectly, by exacerbating food and housing insecurity, for example, or restricting access to medical care. The Biden administration has elevated science and begun to focus on comprehensive approaches to prevention. No longer is federal leadership hawking hydroxychloroquine, suggesting injections with “disinfectant,” or stoking xenophobic sentiment. But this sudden sense of order is a beginning, not an end.’

Read here (The Atlantic, Mar 27, 2021)

Long Covid affects most hospital patients, two UK studies find

‘Most patients treated in hospital for Covid-19 are still suffering a wide range of symptoms five months after discharge — and middle-aged women are even more likely to have long Covid than other groups — according to two UK studies released on Wednesday.

‘The larger study, led by the University of Leicester and called Phosp-Covid, analysed 1,077 people discharged from hospitals across the UK and found that only 29 per cent were fully recovered.

‘The remainder had an average of nine persistent symptoms each. These covered a wide range, including muscle pain and fatigue, breathlessness, pain, joint pain or swelling, weakness, short-term memory loss and “brain fog”.’

Read here (Financial Times, Mar 25, 2021)

A doctor's fight for survival in ICU

‘On Dec 27, 2020, after 23 days in the hospital, I was finally allowed to return home. I was told that my blood parameters and X-ray would only return to normal after many months. All this would not have been possible if not for the prayers and love of my wife, family, friends and God. I was grateful for a strong social support group...

‘It's been a month since I was discharged from the hospital, but my joints still hurt, I suffer from fatigue and shortness of breath when walking far or fast. There is also social stigma as many people won't come near me because I'm a former Covid-19 patient. A friend even declined my small change claiming that the virus would be on it.’

Read here (Malaysiakini, Feb 1, 2021)

Prevalence and risk factors for delirium in critically ill patients with Covid-19: A multicentre cohort study

‘In this large, international cohort study of more than 2000 patients with severe COVID-19, acute brain dysfunction (coma or delirium) was more common and more prolonged than observed in other studies of patients with acute respiratory failure without COVID-19. Patients with COVID-19 also received treatment with sedatives for a prolonged duration: two-thirds of patients were given benzodiazepines and propofol for a median of 7 days. 

‘As a result of the COVID-19 pandemic, many ICUs were operating in resource-constrained environments, and despite demonstrated efficacy in previous studies, evidenced-based strategies, such as light sedation techniques, spontaneous awakening and breathing trials, avoiding benzodiazepines, early mobility, and family visitation, all occurred on fewer than 1 in every 3 days among patients with severe COVID-19. We found that risk of delirium among patients with severe COVID-19 was lower when benzodiazepine sedative infusions were avoided and family was present, whereas greater severity of illness and greater respiratory support was associated with a higher risk of delirium.’

Read here (The Lancet, Jan 8, 2021)

The autopsy, a fading practice, revealed secrets of Covid-19

‘The COVID-19 pandemic has helped revive the autopsy. When the virus first arrived in U.S. hospitals, doctors could only guess what was causing its strange constellation of symptoms: What could explain why patients were losing their sense of smell and taste, developing skin rashes, struggling to breathe and reporting memory loss on top of flu-like coughs and aches?

‘At hospital morgues, which have been steadily losing prominence and funding over several decades, pathologists were busily dissecting the disease’s first victims — and finding some answers. “We were getting emails from clinicians, kind of desperate, asking, ‘What are you seeing?’” said NYU Langone’s Dr. Amy Rapkiewicz. ‘Autopsy,’ she pointed out, means to see for yourself. “That’s exactly what we had to do.”

Read here (AP News, Dec 24, 2020)

The mysterious link between Covid-19 and sleep

‘The coronavirus can cause insomnia and long-term changes in our nervous systems. But sleep could also be a key to ending the pandemic... 

‘The newly discovered coronavirus had killed only a few dozen people when Feixiong Cheng started looking for a treatment. He knew time was of the essence: Cheng, a data analyst at the Cleveland Clinic, had seen similar coronaviruses tear through China and Saudi Arabia before, sickening thousands and shaking the global economy. So, in January, his lab used artificial intelligence to search for hidden clues in the structure of the virus to predict how it invaded human cells, and what might stop it. One observation stood out: The virus could potentially be blocked by melatonin...

‘After he published his research, though, Cheng heard from scientists around the world who thought there might be something to it. They noted that, in addition to melatonin’s well-known effects on sleep, it plays a part in calibrating the immune system. Essentially, it acts as a moderator to help keep our self-protective responses from going haywire—which happens to be the basic problem that can quickly turn a mild case of COVID-19 into a life-threatening scenario.’

Read here (The Atlantic, Dec 22, 2020)

How kids’ immune systems can evade Covid

‘Their immune system sees the virus “and it just mounts this really quick and effective immune response that shuts it down, before it has a chance to replicate to the point that it comes up positive on the swab diagnostic test”, says Melanie Neeland, an immunologist who studied the family, at the Murdoch Children’s Research Institute in Melbourne, Australia.

‘Even in children who experienced the severe but rare complication called multisystem inflammatory syndrome in response to SARS-CoV-2 infection, studies report that the rate of positive results on RT-PCR range from just 29% to 50%.‘

Read here (Nature, Dec 10, 2020)

One in 5 Covid-19 survivors will develop mental illness, a new study found—So we asked an expert why

‘Covid-19 is an infectious disease that causes respiratory illness, but its effects can go way beyond that. A large study from Oxford University in the UK found that survivors are at a higher risk of developing mental illness, such as anxiety and depression. They are also more likely to develop dementia, according to the research, which was published in The Lancet Psychiatry on November 9.

‘The researchers analyzed electronic health records of 69 million people in the US, including more than 62,000 people who had COVID-19. They found that 20% of those infected with the coronavirus were diagnosed with a psychiatric disorder within 90 days—about twice as likely as for other groups of patients with other illnesses in the same time frame.’

Read here (Health, Nov 11, 2020)

Covid outbreak data on US carrier shows a plethora of initial symptoms among the symptomatic, only 5.3% fever : NEJM

‘Among the crew members who had symptomatic Covid-19 (confirmed or suspected), headache was the most common symptom reported at any point during illness (occurring in 68.0%), followed by cough (59.5%), nasal or sinus congestion (43.8%), and altered sense of taste or smell (42.3%) (Figure 3). The predominant symptoms reported at the onset of illness were cough (32.8%), headache (31.0%), and altered sense of taste or smell (24.1%). Shortness of breath at any point during illness was reported by 20.3% of the crew members with symptomatic cases, and 7.0% noted shortness of breath as an initial presenting symptom. In addition, 26.2% of the crew members with symptomatic Covid-19 reported chest pain or chest pressure at some point during their illness. Fever was reported as an initial presenting symptom by 5.3% of the crew members with symptomatic Covid-19, and fever at any point during illness was reported by 13.2%. Measured temperature readings showed that 2.8% of the crew members who had Covid-19 had a recorded temperature of 100.0°F or above, as compared with 0.3% of the crew members who did not have Covid-19. Among the crew members with Covid-19 for whom pulse oximetry data were available, approximately 0.5% had readings below 95% while breathing ambient air, with 0.08% below 94% and none below 90%.’

Read here (New England Journal of Medicine, Nov 11, 2020) 

Lung damage found in Covid dead may shed light on ‘long Covid’: Study

‘A study of the lungs of people who have died from COVID-19 has found persistent and extensive lung damage in most cases and may help doctors understand what is behind a syndrome known as ‘long COVID’, in which patients suffer ongoing symptoms for months. “The findings indicate that COVID-19 is not simply a disease caused by the death of virus-infected cells, but is likely the consequence of these abnormal cells persisting for long periods inside the lungs,” said Mauro Giacca, a professor at King’s College London who co-led the work. In a telephone interview, Giacca said that, while his research team found no overt signs of viral infection or prolonged inflammation in other organs, they discovered “really vast destruction of the architecture of the lungs”, with healthy tissue “almost completely substituted by scar tissue”.

Read here (Reuters, Nov 4, 2020)

Why is coronavirus so deadly?

1. Master of deception: ‘In the early stages of an infection the virus is able to deceive the body. Coronavirus can be running rampant in our lungs and airways and yet our immune system thinks everything is a-ok.’
2. It behaves like a 'hit and run' killer: ‘The amount of virus in our body begins to peak the day before we begin to get sick. But it takes at least a week before Covid progresses to the point where people need hospital treatment.’ 
3. It's new, so our bodies are unprepared: ‘This lack of prior-protection is comparable to when Europeans took smallpox with them to the New World, with deadly consequences.’
4. It does peculiar and unexpected things to the body: ‘Covid starts off as a lung disease (even there it does strange and unusual things) and can affect the whole body.’ Like “corrupting” lung cells, clotting blood and causing runaway inflammation.
5. And we're fatter than we should be: ‘Covid is worse if you are obese, as a generous waistline increases the risk of needing intensive care, or death.’

Read here (BBC, Oct 23, 2020)

What fans of ‘herd immunity’ don’t tell you

‘First, it makes no mention of harm to infected people in low-risk groups, yet many people recover very slowly. More serious, a significant number, including those with no symptoms, suffer damage to their heart and lungs. One recent study of 100 recovered adults found that 78 of them showed signs of heart damage. We have no idea whether this damage will cut years from their lives or affect their quality of life...

‘Second, it says little about how to protect the vulnerable. One can keep a child from visiting a grandparent in another city easily enough, but what happens when the child and grandparent live in the same household? And how do you protect a 25-year-old diabetic, or cancer survivor, or obese person, or anyone else with a comorbidity who needs to go to work every day?...

‘Third, the declaration omits mention of how many people the policy would kill. It’s a lot...If these restrictions are simply eased — as opposed to eliminating them entirely, which would occur if herd immunity were pursued — deaths could rise to as many as 571,527. That’s just by Feb. 1. The model predicts daily deaths will still be increasing then.

‘Will we have achieved herd immunity then? No.’

Read here (New York Times, Oct 19, 2020)

People with blood-group A more susceptible to severe Covid-19

‘Using a pragmatic approach with simplified inclusion criteria and a complementary team of clinicians at the European Covid-19 epicenters in Italy and Spain and scientists in the less-burdened countries of Germany and Norway, we performed a GWAS that included de novo genotyping for Covid-19 with respiratory failure in approximately 2 months. We detected a novel susceptibility locus at a chromosome 3p21.31 gene cluster and confirmed a potential involvement of the ABO blood-group system in Covid-19.’

Read here (New England Journal of Medicine, Oct 15, 2020) 

Covid reinfection: Man gets Covid twice and second hit 'more severe'

‘A man in the United States has caught Covid twice, with the second infection becoming far more dangerous than the first, doctors report. The 25-year-old needed hospital treatment after his lungs could not get enough oxygen into his body. Reinfections remain rare and he has now recovered. But the study in the Lancet Infectious Diseases raises questions about how much immunity can be built up to the virus.’

Read here (BBC, Oct 13, 2020)