Pandemic News Links / Current News Updates

trader32176
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Infections fell 75% after mask mandates and bar closures in Arizona, study shows

10/7/20


https://www.washingtonpost.com/nation/2 ... pdates-us/

Arizona is one of the few states that never made masks mandatory statewide. But allowing cities to impose their own restrictions — while also shutting down businesses like bars and gyms — contributed to a 75 percent drop in coronavirus cases in less than one month, according to a new analysis from the Centers for Disease Control and Prevention.

The state suffered one of the world’s worst coronavirus outbreaks over the summer, with infections peaking after stay-at-home orders were lifted. In mid-June, Gov. Doug Ducey (R) lifted an executive order that had banned communities from imposing mask mandates. Most cities immediately began requiring face coverings in public, and the CDC report estimates that those local ordinances affected roughly 85 percent of the state’s population.

The number of new cases being reported each day stabilized about two weeks later, around the same time that Ducey closed bars, gyms, water parks and movie theaters. With that two-pronged approach in place, the 7-day average of new cases fell 75 percent from July 13 to Aug. 7, the researchers found.

The analysis, published Wednesday in the CDC’s Morbidity and Mortality Weekly Report, notes that officials also urged residents to stay home and wear masks even when not strictly required. Until a vaccine is available, “a combination of voluntary and enforceable measures is more effective than any single measure,” it concluded.
trader32176
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Vitamin D deficiency may predict COVID-19 seroconversion

10/8/20


https://www.news-medical.net/news/20201 ... rsion.aspx

The COVID-19 pandemic has triggered intensive research into the factors that worsen the clinical phenotype, including host, environmental and genetic factors. A recent study published on the preprint server medRxiv* in October 2020 reports the potential contribution of vitamin D deficiency to an increased risk of COVID-19 in a subset of health care workers in the UK.

The Mechanism of Vitamin D Protection


Vitamin D3 deficiency (VDD) results in dysregulated immunity, shown in the form of changes in the form and function of immune cells, especially lymphocytes and monocytes, which render the host especially vulnerable to infection. It is found to be very common in patients with bacterial sepsis and increases the risk of acute respiratory distress syndrome (ARDS) in such patients.

ARDS is known to be a prequel to death in ICU patients hospitalized with COVID-19. Severe illness itself promotes vitamin D deficiency, perhaps because of disruption in the normal metabolism of this vitamin.

Vitamin D is involved in synthesizing a potent steroid hormone that participates in many and varied cellular reactions in many organs. This may explain how it is required for resisting and recovering from inflammation, infection, lung disease, heart failure, and critical illness.

For one, it may promote the generation of antimicrobial compounds in the respiratory mucosa, and has been shown to reduce viral infections of the respiratory tract. It may also attenuate the host response to SARS-CoV-2 after infection occurs. At present, the prevalence of COVID-19 is unduly high among individuals with a Black, Asian, and minority ethnic (BAME) background, even after adjusting for demographic and socioeconomic characteristics, and for the existence of chronic illnesses. However, this group also has an increased risk of VDD.

Again, the risk group for COVID-19 mortality is proportional to the distance from the equator, raising the question of whether sunlight exposure and VDD plays a role in this pattern.

VDD and COVID-19 Risk

The current study follows research indicating that shift workers in the healthcare arena, outside the UK, have a greater risk of VDD than those who work only during the daytime. Junior staff are also at higher risk than those in practice or senior physicians. The study aimed to assess the prevalence of VDD in NHS workers in the UK who isolated for symptoms similar to those of COVID-19, concerning their demographic and occupational characteristics, self-reported symptoms, and the prevalence of actual COVID-19 vs. those with normal vitamin D levels.

There were ~390 healthcare workers in the study. With a median age of 41 years, almost 75% were female, and over 70% white. More than 60% had other chronic illnesses. The level of vitamin D3 was ~56 nmol/l on average. About 16% had VDD, with a mean of 22·0 nmol/l in the vitamin D deficient group vs. ~ 59 nmol/l in the non-deficient group.

The researchers found that being from a BAME background increased the odds of VDD 9-fold, while the chances of being seropositive for COVID-19 were doubled. Using this model, about 78% of cases of VDD were predicted.

Low Symptom Correlation with VDD

Among the 386 patients who self-reported symptoms, a third had a cough, the same percentage had diarrhea, but twice that number had a fever. Almost half of them had difficulty in breathing, with the same number having a sore throat. Over 70% had body pain, almost 90% reported tiredness, and ~45% had abnormalities of taste or smell. Six patients, all with regular vitamin D3 levels, had no symptoms.

About 82% of the VDD group had symptoms like body ache vs. ~70% of the other group. Still, the symptom itself did not predict a lower vitamin D3 level compared to the whole group without this symptom, or to seropositive staff. Other symptoms, even those more characteristic of COVID-19 respiratory infection such as fever and cough, showed no significant difference.

Those with VDD were more likely to be seropositive, at 72% vs ~50%, but the serum levels were not different between seropositive and seronegative workers. This could be because the percentage of seropositives is similar in white and BAME workers with and without VDD. In the latter group, however, males with VDD were more likely to be seropositive (94%) vs. those without, at 52%.

VDD Predicts COVID-19 Seroconversion

The only significant risk indicator for COVID-19 seropositivity was VDD, which predicted over half of all cases, independent of sex, age, BMI, chronic illnesses, ethnicity, and occupation. This is the first time researchers have shown that seropositivity for COVID-19 indicates a higher risk for VDD.

This agrees with an earlier observational study showing that “testing positive for COVID-19 was inversely related to vitamin D levels.”

Implications

VDD is associated with a 45% increased risk of testing positive for COVID-19, and double the odds of requiring hospitalization for the disease. The implication could be either that the risk of COVID-19 is higher with VDD, or that COVID-19 induces VDD as in other critical illnesses. The finding that BAME individuals are more likely to have VDD agrees with earlier studies.

The researchers comment, “While BAME was not an independent risk factor for seroconversion in this cohort, vitamin D deficient BAME male may be the group most at risk from COVID-19.”

All individuals in this cohort had mild COVID-19, but nonetheless, this shows that BAME males are at a higher risk for a poor outcome if they require ICU admission with COVID-19.

The authors point out that “These data raise the question of whether vitamin D supplementation in vitamin D deficient individuals may help alleviate the impact of SARS-Cov-2 if infected.” Some findings of a recent trial seem to indicate that this is a direction worth following.

More research is needed to validate these findings in other settings and a larger cohort, with a broader spectrum of disease and diverse ethnic backgrounds.

However, given that BAME males are at higher risk of VDD and that this is a factor for COVID-19 infection, it would seem that supplementation with vitamin D, which is both cheap and readily available, as well as safe, is worth a try in order to alleviate the risk, especially in clinical trials.

*Important Notice

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.
trader32176
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Pre-existing conditions can increase patient's risk of dying from COVID-19

10/8/20


https://www.news-medical.net/news/20201 ... ID-19.aspx

A large, international study of COVID-19 patients confirmed that cardiovascular disease, hypertension, diabetes, congestive heart failure, chronic kidney disease, stroke and cancer can increase a patient's risk of dying from the virus.

Penn State College of Medicine researchers say their findings may help public health officials improve patient care and develop interventions that can target these high-risk populations.

The researchers found that cardiovascular disease may double a patient's risk of dying from COVID-19. They also discovered that other pre-existing conditions may increase a COVID-19 patient's risk of death by one and a half to three times. The results were recently published in PLOS ONE.

"This study suggests that these chronic conditions are not just common in patients with COVID-19, but their presence is a warning sign to a higher risk of death," said Dr. Paddy Ssentongo, a doctoral student in epidemiology at the College of Medicine and research assistant professor in Penn State's Department of Engineering Science and Mechanics.

"There is a high prevalence of cardiovascular disease and hypertension around the world and in particular, the U.S. With the persistence of COVID-19 in the U.S., this connection becomes crucially important."

The research team conducted a systematic review and meta-analysis of studies published from December 2019 through early July 2020, to determine which chronic conditions put hospitalized patients at risk of dying from COVID-19.

They explored 11 co-existing conditions that pose a risk of severe disease and death among COVID-19 patients including cardiovascular disease, diabetes, high blood pressure, cancer, chronic kidney disease, chronic obstructive pulmonary disease, stroke, congestive heart failure, asthma, chronic liver disease and HIV/AIDS.

Ssentongo and colleagues analyzed data from more than 65,000 patients from 25 studies worldwide. Patients in the selected studies had an average age of 61 years. They found that certain pre-existing health conditions affected survival rates more than others.

When compared to hospitalized COVID-19 patients without pre-existing conditions, researchers determined that patients with diabetes and cancer are 1.5 times more likely to die, patients with cardiovascular disease, hypertension and congestive heart failure are twice as likely to die and patients with chronic kidney disease are three times more likely to die.

" Although the health care community has circulated anecdotal information about the impact of these risk factors in COVID-19 mortality, our systematic review and meta-analysis is the most comprehensive to date that attempts to quantify the risk. As the COVID-19 pandemic continues through 2020 and likely into 2021, we expect that other researchers will build on our work."

-Vernon Chinchilli, Study Senior Author and Distinguished Professor, Chair of Public Health Sciences

The researchers said that prior studies exploring the association of pre-existing chronic conditions and COVID-19 mortality had limitations in the number of countries included, the number of studies included and the number of conditions explored. They also said these studies had unaddressed sources of bias that limited the conclusions that can be drawn from them.

"We took an all-inclusive, global approach for this study by examining 11 chronic conditions and including patients from four continents: Asia, Europe, North America and Africa," Ssentongo adds.

"Research suggests that SARS-CoV-2, the virus that causes COVID-19, may become seasonal and require annual vaccination. Once an approved and effective vaccine is available, high-risk individuals with these pre-existing conditions should receive vaccination priority to prevent high mortality rates."

Even though additional research is needed to fully understand health risks and implications, particularly in understanding the effects of race and ethnicity on COVID-19 survival rates, Ssentongo said these findings can help inform global prevention and treatment strategies.
trader32176
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Researchers launch innovative app for tracking COVID-19 around the world

10/8/20


https://www.news-medical.net/news/20201 ... world.aspx

Contact-tracing and exposure-notification apps are a new technology rapidly developed and launched to respond to the COVID-19 global health crisis.

The development of such applications is placing governments, corporations, and citizens around the world into an ongoing ethical design experiment resulting in potentially life-saving outcomes but also potential risks.

During the summer of 2020, design teams and technology corporations presented governments with a variety of technological solutions in the form of those apps. Government leaders and ordinary citizens have needed to make decisions about which options to endorse and how to govern their use.

Early in the COVID-19 pandemic, as discussions swirled around the adoption of exposure notification or contact-tracing apps, Dr. Teresa Scassa, Dr. Jason Millar, and Dr. Kelly Bronson, and Scotiabank AI + Society Fellows, Tommy Friedlich and Ryan Mosoff, began to explore the privacy and socio-ethical implications related to the creation, adoption and deployment of these apps. As part of this research they gathered data about contact-tracing and exposure-notification apps-and decision-making-around the world.

The website, which was launched today, hosts three main maps; each focuses on different issues: app classification; uptake; voluntariness. There is also a series of country pages providing additional information about contact-tracing and exposure-notification apps adopted in different countries.

The maps are part of a broader research project on the law, policy and socio-ethics aspects of technological response to the pandemic.

App developers and governments need to determine the minimum amount of information to make publicly available regarding app uptake, use and efficacy; such information will influence research like this website but also everyday decisions about downloading and using apps. Considerations include the privacy-preserving aspects of the app, which have technical, legal, and socio-ethical dimensions.
trader32176
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Researchers identify a promising method to stop COVID-19 infection

10/8/20


https://www.news-medical.net/news/20201 ... ction.aspx

While the world waits eagerly for a safe and effective vaccine to prevent infections from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus behind the COVID-19 pandemic, researchers also are focusing on better understanding how SARS-CoV-2 attacks the body in the search for other means of stopping its devastating impact.

The key to one possibility -; blocking a protein that enables the virus to turn the immune system against healthy cells -; has been identified in a recent study by a team of Johns Hopkins Medicine researchers.

Based on their findings, the researchers believe that inhibiting the protein, known as factor D, also will curtail the potentially deadly inflammatory reactions that many patients have to the virus.

Making the discovery even more exciting is that there may already be drugs in development and testing for other diseases that can do the required blocking.

The study is published in the Sept. 2, 2020, issue of the journal Blood.

Scientists already know that spike proteins on the surface of the SARS-CoV-2 virus -; making the pathogen look like the spiny ball from a medieval mace -; are the means by which it attaches to cells targeted for infection.

To do this, the spikes first grab hold of heparan sulfate, a large, complex sugar molecule found on the surface of cells in the lungs, blood vessels and smooth muscle making up most organs.

Facilitated by its initial binding with heparan sulfate, SARS-CoV-2 then uses another cell-surface component, the protein known as angiotensin-converting enzyme 2 (ACE2), as its doorway into the attacked cell.

The Johns Hopkins Medicine team discovered that when SARS-CoV-2 ties up heparan sulfate, it prevents factor H from using the sugar molecule to bind with cells.

Factor H's normal function is to regulate the chemical signals that trigger inflammation and keep the immune system from harming healthy cells. Without this protection, cells in the lungs, heart, kidneys and other organs can be destroyed by the defense mechanism nature intended to safeguard them.

" Previous research has suggested that along with tying up heparan sulfate, SARS-CoV-2 activates a cascading series of biological reactions -; what we call the alternative pathway of complement, or APC -; that can lead to inflammation and cell destruction if misdirected by the immune system at healthy organs. The goal of our study was to discover how the virus activates this pathway and to find a way to inhibit it before the damage happens."

-Robert Brodsky, MD, Study Senior Author and Director, Hematology Division, Johns Hopkins University School of Medicine

The APC is one of three chain reaction processes involving the splitting and combining of more than 20 different proteins -; known as complement proteins -; that usually gets activated when bacteria or viruses invade the body.

The end product of this complement cascade, a structure called membrane attack complex (MAC), forms on the surface of the invader and causes its destruction, either by creating holes in bacterial membranes or disrupting a virus' outer envelope.

However, MACs also can arise on the membranes of healthy cells. Fortunately, humans have a number of complement proteins, including factor H, that regulate the APC, keep it in check and therefore, protect normal cells from damage by MACs.

In a series of experiments, Brodsky and his colleagues used normal human blood serum and three subunits of the SARS-CoV-2 spike protein to discover exactly how the virus activates the APC, hijacks the immune system and endangers normal cells.

They discovered that two of the subunits, called S1 and S2, are the components that bind the virus to heparan sulfate -; setting off the APC cascade and blocking factor H from connecting with the sugar -; and in turn, disabling the complement regulation by which factor H deters a misdirected immune response.

In turn, the researchers say, the resulting immune system response to chemicals released by the lysing of killed cells could be responsible for the organ damage and failures seen in severe cases of COVID-19.

Most notably, Brodsky says, the research team found by blocking another complement protein, known as factor D, which works immediately upstream in the pathway from factor H, they were able to stop the destructive chain of events triggered by SARS-CoV-2.

"When we added a small molecule that inhibits the function of factor D, the APC wasn't activated by the virus spike proteins," Brodsky says. "We believe that when the SARS-CoV-2 spike proteins bind to heparan sulfate, it triggers an increase in the complement-mediated killing of normal cells because factor H, a key regulator of the APC, can't do its job."

To better understand what happens, Brodsky says think of the APC like a car in motion.

"If the brakes are disabled, the gas pedal can be floored without restraint, very likely leading to a crash and destruction," he explains. "The viral spike proteins disable the biological brakes, factor H, enabling the gas pedal, factor D, to accelerate the immune system and cause cell, tissue and organ devastation. Inhibit factor D, and the brakes can be reapplied and the immune system reset."

Brodsky adds that cell death and organ damage from a misdirected APC associated with factor H suppression is already known to occur in several complement-related human diseases, including age-related macular degeneration, a leading cause of vision loss for people age 50 and older; and atypical hemolytic uremic syndrome (aHUS), a rare disease that causes clots to block blood flow to the kidneys.

Brodsky and his colleagues hope that their work will encourage more study into the potential use against COVID-19 of complement-inhibiting drugs already in the pipeline for other diseases.

"There are a number of these drugs that will be FDA-approved and in clinical practice within the next two years," Brodsky says. "Perhaps one or more of these could be teamed with vaccines to help control the spread of COVID-19 and avoid future viral pandemics."
trader32176
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Long-term exposure to urban air pollution may make COVID-19 more deadly

10/8/20


https://www.news-medical.net/news/20201 ... eadly.aspx

As the pandemic persists, COVID-19 has claimed more than 200,000 lives in the United States and damaged the public health system and economy. In a study published on September 21 in the journal The Innovation, researchers at Emory University found that long-term exposure to urban air pollution may have made COVID-19 more deadly.

" Both long-term and short-term exposure to air pollution has been associated with direct and indirect systemic impact on the human body by enhancing oxidative stress, acute inflammation, and respiratory infection risk."

- Donghai Liang of Emory University, co-first author on the paper along with Liuhua Shi

The researchers analyzed key urban air pollutants, including fine particle matter (PM2.5), nitrogen dioxide (NO2), and ozone (O3), across 3,122 counties in the United States from January to July. To examine the association between ambient air pollutants and the severity of COVID-19 outcomes, they investigated two major death outcomes, the case-fatality rate (i.e., number of deaths among the people who are diagnosed with COVID-19) and the mortality rate (i.e., number of COVID-19 deaths in the population). The two indicators can imply the biological susceptibility to deaths from COVID-19 and offer information of the severity of the COVID-19 deaths in the general population, respectively.

Of the pollutants analyzed, NO2 had the strongest independent correlation with raising a person's susceptibility to death from COVID-19. A 4.6 parts per billion (ppb) increase of NO2 in the air was associated with 11.3% and 16.2% increases in COVID-19 case-fatality and mortality rate, respectively. Moreover, Liang and his colleagues discovered that just a 4.6 ppb reduction in long-term exposure to NO2 would have prevented 14,672 deaths among those who tested positive for the virus. The team also observed a margin-ally significant association between PM2.5 exposure and COVID case-fatality rate, whereas no notable associations were found with O3.

"Long-term exposure to urban air pollution, especially nitrogen dioxide, might enhance populations' susceptibility to severe COVID-19 death outcomes," says Liang. "It's es-sential to deliver this message to public health practitioners and policymakers in order for them to consider protecting vulnerable populations that lived in historically high NO2 pollution including the metropolitan areas in the state of New York, New Jersey, California, and Arizona."

Liang also noted that air pollution is a health equity issue: the burden of NO2 pollution is not evenly shared. People with lower income and people of color often face higher exposure to ambient air pollution and may experience a more significant impact from the pollutants. Not having many choices in residency, many live by highways or industrial sites, which makes them especially vulnerable to air pollution.

"The continuations and expansions of current efforts to lower traffic emissions and ambient air pollution might be an important component of reducing the population-level risk of COVID-19 case-fatality and mortality in the United States," says Liang.
trader32176
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Clear and unequivocal evidence we should washing our hands during COVID-19

10/9/20


https://www.news-medical.net/news/20201 ... ID-19.aspx

The coronavirus disease (COVID-19) pandemic is still actively spreading in many countries, including the United States. There is still no approved treatment or vaccine against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes COVID-19. However, effective infection control measures such as social distancing, proper wearing of masks, and regular handwashing can help contain its spread.

Now, the U.S. Centers for Disease Control and Prevention (CDC) released a new report that aims to determine if Americans wash their hands amid the threat of the coronavirus pandemic.

The study shows that Americans are washing their hands much more they did before the coronavirus pandemic. However, the groups who are less likely to remember to wash their hands on multiple occasions were white people, men, and those between the ages of 18 and 24.

The study

Hand hygiene is an essential measure to prevent the spread of COVID-19 and other infections. Public health efforts should promote regular hand hygiene for everyone, as it helps prevent infection and promote proper personal hygiene.

Amid the coronavirus pandemic, governments and health experts across the globe recommend that people should always wash their hands if they have respiratory symptoms, if they touched commonly-touched surfaces, before and after eating, and after using the bathroom.

Previous studies have shown moderate to high levels of self-reported handwashing among adults globally during the pandemic. Still, there is little information known about how handwashing behavior among Americans has changed since the emergence of COVID-19 in the country.

In the study, the researchers collected data between October 2019 and June 2020 on how adults remember to wash their hands in six situations – after using the bathroom at home, after using the bathroom in public, after coughing, sneezing, or blowing one’s nose, before eating at home, before eating at a restaurant, and before preparing food at home.

The team obtained data from over 7,600 study respondents. A total of 3,624 participants answered the ConsumerStyles survey between October 8 and 22, 2019, and about 4,053 respondents completed the survey between June 10 and 25, 2020.

Aside from handwashing behavior, the researchers also collected data about demographic characteristics, annual household income, household size, employment status, and perceived health status.

Higher levels of handwashing

The team has found significant increases in reported handwashing in June 2020, during the pandemic, compared with October 2019 in four out of six situations. Further, adults were 2.3 times more likely to remember to wash their hands after coughing, sneezing, or blowing their nose, two times more likely before eating at a restaurant, and 1.7 times higher before eating at home.

However, the team also revealed that men, young adults between the ages of 18 and 24, and white adults were less likely to remember to wash their hands in multiple situations.

The study findings highlight the importance of encouraging proper hand hygiene, particularly in groups reporting a low prevalence of remembering to wash their hands. The respondents also reported frequently washing their hands before preparing food at home both in 2019 and 2020, after using the bathroom at home, and after using a public bathroom. However, the less commonly reported remembering to wash hands in 2019 in situations like before eating at home, before eating at a restaurant, and after coughing, sneezing or blowing their nose, and these all improved in 2020 during the pandemic. During these situations, adults were more likely to wash their hands to prevent COVID-19 infection.

“Public health efforts should promote frequent handwashing for all, with attention to tailoring messaging to men, young adults, and non-Hispanic White adults. Particular focus should be placed on encouraging handwashing at important times, such as before eating and after experiencing respiratory symptoms,” the researchers wrote in the paper.

The CDC recommends infection control measures to prevent the spread of SARS-CoV-2, which has now infected more than 7.60 million people and killed over 212,000 in the United States. Globally, the number of cases topped 36.44 million, and the death toll has reached well over 1 million.

The CDC reports that the best way to prevent illness is to avoid being exposed to the virus. It urged people to frequently wash their hands, avoid close contact with other people, cover the mouth and nose with a mask, cover the mouth and nose when coughing or sneezing, and disinfect contaminated surfaces.
trader32176
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86 percent of the UK's COVID-19 patients have no symptoms

10/9/20


https://www.news-medical.net/news/20201 ... ptoms.aspx

Many people who contract the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes the coronavirus disease (COVID-19), develop only mild and moderate symptoms. A small fraction of those infected develop severe symptoms, which usually occur in people who are at higher risk due to comorbidities.

Now, a new study by researchers at the University College London revealed that 86 percent of people who tested positive for COVID-19 did not have virus symptoms, such as cough, fever, and loss of taste or smell. The study findings, collected by the Office for National Statistics, the U.K. statistics body, highlight the role of asymptomatic patients in the spread of the virus.

The data collecting body gathered information about coronavirus testing from thousands of British households during the pandemic—the asked households whether they developed symptoms or not.

“To reduce transmission of SARS-CoV-2, it is important to identify those who are infectious. However, little is known about what proportion of infectious people are asymptomatic and potential “silent” transmitters. We evaluated the value of COVID-19 symptoms as a marker for SARS-CoV-2 infection from a representative English survey,” the authors wrote in the paper.

COVID-19 symptoms among infected people


The study, published in the journal Clinical Epidemiology, utilized data from the Coronavirus Infection Survey, an extensive population-based survey looking at the link between coronavirus symptoms and test results.

Over 36,000 people living in Northern Ireland, England, and Wales were included in the study, who were tested from April to June. Of the total participants, 0.32 percent of 115 people had a positive test result. From there, the team focused on these individuals to determine specific symptoms.

Of the 115 people who tested positive with SARS-CoV-2, 16 or 13.9 percent reported symptoms, while 99 people or 86.1 percent of the patients, did not report any specific symptoms on the day of the test.

Further, 27 or 23.5 percent were symptomatic, and 88 or 76.5 percent did not manifest symptoms on the day of the test.

“COVID-19 symptoms are poor markers of SARS-CoV-2. Thus, 76.5% of this random sample, which tested positive reported no symptoms, and 86.1% reported none of those specific to COVID-19. A more widespread testing program is necessary to capture “silent” transmission and potentially prevent and reduce future outbreaks,” the team concluded in the study.

The researchers believe that the study findings may provide critical information for ongoing and future testing programs.

“The fact that so many people who tested positive were asymptomatic on the day of a positive test result calls for a change to future testing strategies. More widespread testing will help to capture “silent” transmission and potentially prevent future outbreaks,” Professor Irene Petersen from UCL Epidemiology & Health Care, said.

“Future testing programs should involve frequent testing of a wider group of individuals, not just symptomatic cases, especially in high-risk settings or places where many people work or live close together such as meat factories or university halls. In the case of university halls, it may be particularly relevant to test all students before they go home for Christmas,” the added.

He also explained that pooled testing could impose a widespread testing strategy, where multiple tests can be grouped into one analysis. This way, they could save time and money rather than doing individual tests.

COVID-19 situation

The United Kingdom reports a second wave of the coronavirus outbreak in the country, which topped more than 564,000 cases and at last 42,000 deaths. Health minister Matt Hancock warned that the U.K. is reporting skyrocketing cases. On Oct. 8, more than 17,540 new daily COVID-19 cases were recorded, which is up by more than 3,000 from the previous day.

Also, 77 people had died after testing positive for COVID-19 within 28 days. The number of patients hospitalized due to the infection increased to a whopping 3,044 from 2,944 the previous day.

Globally, the number of cases has surpassed 36.44 million and the death toll has now reached over 1 million.
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Blocking immune system pathway may stop COVID-19 infection, prevent severe organ damage

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Blocking immune system pathway may stop COVID-19 infection, prevent severe organ damage

https://www.eurekalert.org/pub_releases ... 100720.php

While the world waits eagerly for a safe and effective vaccine to prevent infections from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus behind the COVID-19 pandemic, researchers also are focusing on better understanding how SARS-CoV-2 attacks the body in the search for other means of stopping its devastating impact. The key to one possibility -- blocking a protein that enables the virus to turn the immune system against healthy cells -- has been identified in a recent study by a team of Johns Hopkins Medicine researchers.

Based on their findings, the researchers believe that inhibiting the protein, known as factor D, also will curtail the potentially deadly inflammatory reactions that many patients have to the virus.

Making the discovery even more exciting is that there may already be drugs in development and testing for other diseases that can do the required blocking.

The study is published in the Sept. 2, 2020, issue of the journal Blood.

Scientists already know that spike proteins on the surface of the SARS-CoV-2 virus -- making the pathogen look like the spiny ball from a medieval mace -- are the means by which it attaches to cells targeted for infection. To do this, the spikes first grab hold of heparan sulfate, a large, complex sugar molecule found on the surface of cells in the lungs, blood vessels and smooth muscle making up most organs. Facilitated by its initial binding with heparan sulfate, SARS-CoV-2 then uses another cell-surface component, the protein known as angiotensin-converting enzyme 2 (ACE2), as its doorway into the attacked cell.

The Johns Hopkins Medicine team discovered that when SARS-CoV-2 ties up heparan sulfate, it prevents factor H from using the sugar molecule to bind with cells. Factor H's normal function is to regulate the chemical signals that trigger inflammation and keep the immune system from harming healthy cells. Without this protection, cells in the lungs, heart, kidneys and other organs can be destroyed by the defense mechanism nature intended to safeguard them.

"Previous research has suggested that along with tying up heparan sulfate, SARS-CoV-2 activates a cascading series of biological reactions -- what we call the alternative pathway of complement, or APC -- that can lead to inflammation and cell destruction if misdirected by the immune system at healthy organs," says study senior author Robert Brodsky, M.D., director of the hematology division at the Johns Hopkins University School of Medicine. "The goal of our study was to discover how the virus activates this pathway and to find a way to inhibit it before the damage happens."

The APC is one of three chain reaction processes involving the splitting and combining of more than 20 different proteins -- known as complement proteins -- that usually gets activated when bacteria or viruses invade the body. The end product of this complement cascade, a structure called membrane attack complex (MAC), forms on the surface of the invader and causes its destruction, either by creating holes in bacterial membranes or disrupting a virus' outer envelope. However, MACs also can arise on the membranes of healthy cells. Fortunately, humans have a number of complement proteins, including factor H, that regulate the APC, keep it in check and therefore, protect normal cells from damage by MACs.

In a series of experiments, Brodsky and his colleagues used normal human blood serum and three subunits of the SARS-CoV-2 spike protein to discover exactly how the virus activates the APC, hijacks the immune system and endangers normal cells. They discovered that two of the subunits, called S1 and S2, are the components that bind the virus to heparan sulfate -- setting off the APC cascade and blocking factor H from connecting with the sugar -- and in turn, disabling the complement regulation by which factor H deters a misdirected immune response.

In turn, the researchers say, the resulting immune system response to chemicals released by the lysing of killed cells could be responsible for the organ damage and failures seen in severe cases of COVID-19.

Most notably, Brodsky says, the research team found by blocking another complement protein, known as factor D, which works immediately upstream in the pathway from factor H, they were able to stop the destructive chain of events triggered by SARS-CoV-2.

"When we added a small molecule that inhibits the function of factor D, the APC wasn't activated by the virus spike proteins," Brodsky says. "We believe that when the SARS-CoV-2 spike proteins bind to heparan sulfate, it triggers an increase in the complement-mediated killing of normal cells because factor H, a key regulator of the APC, can't do its job."

To better understand what happens, Brodsky says think of the APC like a car in motion.

"If the brakes are disabled, the gas pedal can be floored without restraint, very likely leading to a crash and destruction," he explains. "The viral spike proteins disable the biological brakes, factor H, enabling the gas pedal, factor D, to accelerate the immune system and cause cell, tissue and organ devastation. Inhibit factor D, and the brakes can be reapplied and the immune system reset."

Brodsky adds that cell death and organ damage from a misdirected APC associated with factor H suppression is already known to occur in several complement-related human diseases, including age-related macular degeneration, a leading cause of vision loss for people age 50 and older; and atypical hemolytic uremic syndrome (aHUS), a rare disease that causes clots to block blood flow to the kidneys.

Brodsky and his colleagues hope that their work will encourage more study into the potential use against COVID-19 of complement-inhibiting drugs already in the pipeline for other diseases.

"There are a number of these drugs that will be FDA-approved and in clinical practice within the next two years," Brodsky says. "Perhaps one or more of these could be teamed with vaccines to help control the spread of COVID-19 and avoid future viral pandemics."

###

Along with Brodsky, the other members of the Johns Hopkins Medicine research team are lead author Jia Yu; Xuan Yuan; Hang Chen; Shruti Chaturvedi, M.B.B.S.; and Evan Braunstein, M.D., Ph.D.

The study was supported by National Heart, Lung and Blood Institute grant R01 HL133113.

Disclaimer: Johns Hopkins Medicine researchers are working tirelessly to find ways to better understand and eventually eliminate COVID-19 and the virus that causes it. Discoveries like this one, especially those related to clinical therapies and drug regimens, are still early in concept and small in sample size. This will require rigorous research, testing and peer review, all of which take time, before solid conclusions for clinical care and disease prevention can be made.
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Ottawa Public Health receiving new metric to help measure COVID-19 levels in wastewater

10/9/20


https://www.news-medical.net/news/20201 ... water.aspx


Ottawa Public Health (OPH) is receiving new metric to help measure levels of COVID-19 in the community: wastewater.

The National Capital Region is one of the first communities in Canada to conduct daily wastewater readings to help inform its community response in the fight against COVID-19, thanks to innovative research from the CHEO Research Institute (CHEO RI) and the University of Ottawa (uOttawa).

Tracking the number of daily positive cases of COVID-19 is one option to gauge the level of COVID activity in the community. However, since not everyone who has COVID-19 is tested, those numbers may not provide an accurate reading of the whole COVID-19 picture in the population. Furthermore, testing can be a lengthy process and results may take several days to become available.

A promising new public health metric provides early readings of SARS-CoV-2 activity: coronavirus RNA in wastewater. A significant proportion of people with active COVID-19 infections shed the coronavirus (called SARS-VCoV-2) in their stool, sometimes even before their symptoms appear or whether they have symptoms at all.

For the past several months a team of researchers, led by Professor Robert Delatolla from the University of Ottawa and Dr. Alex Mackenzie from the CHEO Research Institute, has been conducting wastewater testing and refining their approach. Currently, five days a week, wastewater is collected and transported to a laboratory where RNA produced from the virus are immediately tested and results are reported the next morning.

Measuring COVID-19 in wastewater has the potential to help OPH and other health agencies measure the level of COVID-19 present in our community, possibly even serving as an early warning system, as we continue to find better early indicators to help in the fight against COVID-19.

For more information on this research, and to obtain the daily presentation of the data, please visit Measuring COVID-19 indicators in Ottawa.
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"This research showed strong potential from its earliest phases," said Dr. Monir Taha, Associate Medical Officer of Health at Ottawa Public Health. "Now that OPH is receiving daily results, we are getting a good feel of how the wastewater data match or even predict the human test results. We are particularly interested in looking for increases in wastewater findings as an early signal after there has been a downturn in COVID-19 activity."

"We are excited that our wastewater based community COVID readings shall be shared with our public health experts but also all Ottawa residents as we negotiate the pandemic" said Dr. Alex MacKenzie, Senior Scientist at the CHEO Research Institute, who is co-lead of the study. "Since early September, we have witnessed gradual but significant overall increases in CoV2 traces in Ottawa wastewater consistent with a growing community COVID 19 presence. Of particular concern, some recent daily spikes have even exceeded those seen during last spring's peak activity signaling to all the need for vigilance in physical distancing wherever possible."

"This is very exciting! Our overall goal was to develop an epidemiological tool to identify the prevalence of the virus and identify significant increases of the virus in communities ahead of an outbreak," explained Robert Delatolla, Associate Professor at the uOttawa Faculty of Engineering and study co-lead. "We are thrilled to see that it can have practical applications right here in the region and provide a means to identify resurgences of viral prevalence in communities."
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