Carbon Chemist

Tag: Respiratory

  • Man takes 217 COVID vaccines with no ill effects, shows immune boost

    Man takes 217 COVID vaccines with no ill effects, shows immune boost

    [ad_1]

    In a recent case report published in The Lancet Infectious Diseases, researchers described a case of a 62-year-old male who received 217 vaccinations against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in 29 months and examined his immunological responses. They found that hyper-vaccination did not cause adverse events or significantly affect the quality of adaptive immune responses while resulting in increased T-cells and spike-specific antibodies.

    Study: Adaptive immune responses are larger and functionally preserved in a hypervaccinated individual. Image Credit: Douglas Sacha / ShutterstockStudy: Adaptive immune responses are larger and functionally preserved in a hypervaccinated individual. Image Credit: Douglas Sacha / Shutterstock

    Background

    Booster vaccinations may potentially amplify immune responses, while persistent antigen exposure may induce immune tolerance. However, the advantages, constraints, and risks of recurrent vaccination in humans remain to be thoroughly investigated. In the present study, researchers investigated the immunological responses in an older man hyper-vaccinated against SARS-CoV-2.

    The case

    In this case study, a 62-year-old male from Magdeburg, Germany (referred to as HIM), engaged in deliberate hyper-vaccination against SARS-CoV-2, receiving 217 vaccinations over 29 months for personal reasons. This occurred outside a clinical study context and contrary to national recommendations. Despite an investigation by a public prosecutor for potential fraud, no criminal charges were filed. Notably, HIM’s immunological evaluation, initiated during the public prosecutor’s investigation, received active and voluntary cooperation from HIM and was ethically approved. Throughout the extensive hyper-vaccination, HIM reported no vaccine-related side effects, and routine clinical chemistry parameters displayed no abnormalities between November 2019 and October 2023. In the repeated negative SARS-CoV-2 tests, including antigen tests, polymerase chain reaction (PCR) test, and nucleocapsid serology, HIM showed no signs of past SARS-CoV-2 infection.

    Starting from the 214th vaccination, HIM’s anti-spike SARS-CoV-2 immunoglobulin G (IgG) levels were measured before and after vaccinations. The antibody peak occurred at the 214th vaccination, and there was a slight increase after the 217th vaccination. Additionally, HIM showed IgG4 subclass switching after the 215th vaccination, which is uncommon in regimens with adenoviral-based vaccines as the first dose.

    A total of 29 individuals who received three doses of a messenger ribonucleic acid (mRNA) vaccine formed the control group. As compared to controls, HIM exhibited mildly elevated levels of anti-spike IgM and IgA in the serum. However, in saliva samples, HIM showed detectable levels of anti-spike IgG, contrary to the control participants. HIM’s serum neutralization capacity was higher (5.4-fold for wildtype and 11.5-fold for Omicron B1.1.529 spike proteins) than the controls, indicating elevated quantities of spike-specific IgG. This observed difference was not attributed to antibody avidity as it remained comparable among the groups.

    HIM showed a slightly increased number of spike-specific B-cells, with the same phenotype as seen in single-cell RNA sequencing (scRNA-seq). No significant differences were observed in the rates of somatic hypermutation or clonal expansion. CD8+ T-cells specific to the spike epitope were about six-fold more frequent in HIM, with a preference for effector memory T-cells. Further, scRNA-seq of LTD-specific T-cells showed a more differentiated phenotype and increased clonal expansion compared to controls. Flow-cytometric analysis and metabolic profiling showed no significant abnormalities in 14 protein markers.

    LTD-specific CD8+ T-cells in HIM showed a proliferative capacity similar to control individuals, aligned with conserved numbers of T-cells with a phenotype like early differentiated stem cells. After epitope-specific stimulation, HIM displayed higher cytokine-positive cells, but the cytokine release per cell remained roughly equal. Cytokine analysis in the supernatant revealed the typical pattern of virus-specific CD8+ T-cells. Additionally, HIM’s CD8+ T-cells showed higher peptide sensitivity than the control group. Examination of spike-reactive CD4+ T-cells revealed a dearth of nucleocapsid-specific immunity, with similar cytokine-producing CD4+ T-cell amounts in HIM compared to the control group while retaining peptide sensitivity.

    Conclusion

    In conclusion, the present case report showed that hyper-vaccination against SARS-CoV-2 yielded no adverse events and elevated T-cell levels and spike-specific antibodies. Notably, the implicit quality of adaptive immune responses showed no significant effects. Although breakthrough SARS-CoV-2 infections were not observed in the individual, any causal link with the hyper-vaccination regimen remains unclear. The researchers emphasize that they do not advocate for hyper-vaccination as an approach to improve adaptive immunity.

    [ad_2]

    Source link

  • A call for better diagnosis and treatment

    A call for better diagnosis and treatment

    [ad_1]

    In a recent review published in the journal Nature Reviews Microbiology, a group of authors summarized recent advancements in understanding long coronavirus disease (COVID) ‘s mechanisms, impacts, and research needs for better diagnostics and treatments.

    Review: Long COVID: major findings, mechanisms and recommendationsReview: Long COVID: major findings, mechanisms and recommendations

    Background

    Long COVID, affecting over 65 million globally, manifests through diverse, systemic symptoms regardless of initial infection severity. This condition leads to various health issues like cardiovascular diseases and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), causing widespread disability and workforce impacts. Pathogenesis theories include persistent viral presence and immune dysregulation, but no effective treatments have been established. Research has identified risk factors such as gender and socioeconomic status, although many patients had no prior conditions. Long COVID’s resemblance to other post-viral syndromes underscores the urgent need for research into its mechanisms, risk factors, and treatments to enhance patient outcomes.

    Immunological and virological discoveries in Long COVID

    Long COVID triggers significant immune changes, particularly post-mild COVID, marked by T cell exhaustion, reduced effector memory Cluster of Differentiation (CD)4+ and CD8+ T cells, elevated Programmed Death-1 (PD1) expression, and activated innate immune responses. The scarcity of naive T and B cells, alongside sustained high type I and III interferon levels, indicates continued immune dysregulation. An altered immune cell balance, including increased non-classical monocytes, reduced dendritic cells, and low cortisol, highlights a distinct immune profile in long COVID.

    Research points to autoimmunity in long COVID, highlighted by raised autoantibodies against key receptors like Angiotensin-Converting Enzyme 2 (ACE2). Viral reactivations, notably of Epstein-Barr Virus (EBV) and Human Herpesvirus 6 (HHV-6), which impact mitochondrial function and energy metabolism, play a significant role. The condition’s development is initially linked to inadequate immune responses, including poor antibody and T-cell response. Signs of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) persistence across multiple body tissues suggest a potential mechanism for the enduring nature of long COVID symptoms.

    Systemic impact and organ damage

    SARS-CoV-2 causes widespread organ damage beyond the respiratory system, affecting the circulatory system through endothelial dysfunction and increased thrombosis risks. Long-term alterations in blood properties and vascular density contribute to the heightened prevalence of cardiovascular diseases post-COVID, demonstrating the virus’s systemic and lasting effects.

    Neurological impact

    Long COVID induces neurological and cognitive issues, such as memory loss and cognitive impairment, with effects comparable to significant aging. Potential underlying mechanisms like neuroinflammation and neuronal damage link these symptoms to Alzheimer’s-like pathology, highlighting severe brain impacts.

    ME/CFS and related conditions

    There is a notable overlap between long COVID and ME/CFS, with many patients meeting the criteria for the latter. This relationship underscores commonalities like immune alterations and mitochondrial dysfunction, with dysautonomia commonly co-occurring, suggesting shared pathophysiological mechanisms.

    Reproductive and respiratory concerns

    Long COVID’s reproductive effects call for focused research on sex-specific impacts, while persistent respiratory symptoms underscore lasting lung damage. These aspects illustrate the condition’s broad spectrum of effects.

    Gastrointestinal symptoms and chronicity

    Persistent gastrointestinal issues and altered gut microbiota in long COVID patients emphasize its systemic nature. The diverse onset and duration of symptoms across patients highlight the condition’s complexity and the challenge of predicting individual outcomes.

    Diagnostic advances and challenges

    Diagnostic approaches for long COVID are under development, with existing techniques like tilt table tests and Magnetic Resonance Imaging (MRI) scans often failing to detect the condition effectively. Emerging diagnostics, including microclot imaging, corneal microscopy, and novel Electrocardiogram (ECG) markers, offer hope for more precise identification. Research into biomarkers and unconventional methods, such as scent detection by dogs, highlights the innovative directions being explored to improve long COVID diagnosis.

    Treatment landscape and future directions

    Current treatment strategies for long COVID are primarily symptom-focused, with some success using methods adapted from ME/CFS management. Innovations such as low-dose naltrexone and anticoagulant therapy show promise, while experimental treatments like Paxlovid and probiotics are beginning to demonstrate potential benefits. Nonetheless, the need for rigorous clinical trials to establish effective treatments remains critical, underscoring the initial stage of long COVID care and the importance of ongoing research.

    Vaccine impact and the role of variants

    Vaccination’s impact on long COVID varies, showing both minimal and reduced risk. Variants and vaccine doses may affect long COVID chances, with early studies hinting at variant-dependent risks and vaccine efficacy. Reinfections, particularly multiple ones, could heighten long COVID risks, stressing the importance of continuous research and monitoring.

    Diagnosing Long COVID: obstacles and solutions

    The early pandemic’s diagnostic challenges, such as limited polymerase chain reaction (PCR) test availability and high false-negative rates, led to widespread underdiagnosis, affecting mainly non-hospitalized individuals. Compounded by unreliable antibody tests, particularly among specific groups like women, children, and those with mild infections, these issues have significantly hindered long COVID research and patient care. Misclassification and study exclusion have clouded our understanding of the condition. A comprehensive approach incorporating insights from ME/CFS and dysautonomia is essential to improve long COVID research. Emphasizing clinical trials, diverse participant inclusion, and engaging patient communities, alongside updated healthcare training, will enhance patient outcomes and advance our knowledge of long COVID.

    [ad_2]

    Source link

  • Can postbiotics improve athletic performance and recovery?

    Can postbiotics improve athletic performance and recovery?

    [ad_1]

    A recent systematic review published in Nutrients describes the utility of postbiotics in improving exercise performance and recovery.

    Study: It’s Dead! Can Postbiotics Really Help Performance and Recovery? A Systematic Review. Image Credit: Doucefleur / Shutterstock.com

    Probiotics vs. postbiotics

    Probiotics are live microorganisms that are associated with a wide variety of health benefits to the host when administered adequately. For example, probiotics can support gut health, improve mental health, prevent cardiometabolic diseases, improve sleep quality and duration, as well as reduce allergic reactions. Probiotics exert these health benefits through their effects on the immune system by reducing intestinal pH, maintaining intestinal barrier integrity, increasing gut microbial composition and diversity, reducing inflammation, and eliminating pathogens.

    Recently, the International Society of Sports and Nutrition has stated that probiotics might be beneficial for improving exercise performance and recovery, in addition to supporting the training and competition demands of athletes.

    In addition to probiotics, postbiotics have recently gained considerable attention in healthcare due to their potential ability to improve health. A significant advantage of using postbiotics for health purposes is their longer shelf-life and reduced susceptibility to degradation due to changes in ambient conditions.

    According to the International Scientific Association of Probiotics and Prebiotics (ISAPP), a postbiotic is defined as a preparation of inanimate microorganisms and/or their components that confers health benefits. Existing evidence indicates that postbiotics can exert positive health effects on gastrointestinal, dermatological, and respiratory diseases.

    Some of the different methods used to produce postbiotic preparations from live microorganisms include heat treatment, sonification, chemical treatment, and ultraviolet (UV) irradiation. Each method, as well as the processing condition, has a differential impact on the functionality of resulting postbiotics.

    About the study

    The authors systematically searched various electronic databases to identify studies that investigated the impact of postbiotic supplementation, specifically on exercise performance, recovery, as well as biomarkers related to muscle immune function, inflammation, and oxidative stress.

    Only peer-reviewed, randomized, double-blind, and placebo-controlled trials involving healthy adults were included in the systematic analysis. Postbiotic supplements used in these studies included paraprobiotics, Tyndallized probiotics, ghost biotics, heat-killed probiotics, inactivated probiotics, and nonviable probiotics. The different outcomes measured in these studies included exercise, exercise performance, and recovery.    

    Systematic review findings

    A total of 11 studies, including nine peer-reviewed papers and two conference abstracts, were included in the final review. These studies comprised a total of 477 participants and postbiotic supplementation periods ranging from 13 days to 12 weeks.

    Three studies directly compared the probiotic and postbiotic preparations of the same strains, including Lactiplantibaccilus plantarum TWK10, Lacticaseibacillus paracasei PS23, and Weizmannia coagulans GBI-30 6086.

    In one study investigating probiotic and postbiotic preparations of Weizmannia coagulans GBI-30 6086, none of the preparations were found to modulate the performance of healthy individuals participating in stressful lower-body exercises.

    Another comparative study showed that both probiotic and postbiotic preparations of Lacticaseibacillus paracasei PS23 can reduce the rate of muscle damage caused by maximal vertical jump, facilitate faster recovery, and improve fatigue as compared to placebo. However, only the postbiotic preparation was associated with a greater ability than the probiotic preparation to improve strength recovery.

    In one study investing probiotic and postbiotic preparations of Lactiplantibaccilus plantarum TWK10, both preparations similarly improved exercise performance. However, the probiotic preparation was superior than the postbiotic preparation in reducing glucose, lactate, and ammonia levels in response to exercise stimuli. This study also reported an increased inflammatory response to exercise in individuals supplemented with the postbiotic preparation.

    Another study investigating the effects of a postbiotic preparation of Weizmannia coagulans GBI-30 6086 reported enhanced lower body power and anti-inflammatory profiles in soldiers. Similarly, one study investigating a postbiotic preparation of Lactiplantibaccilus plantarum TWK10 revealed improvements in endurance performance, grip strength, and muscle mass in healthy exercising males.    

    Regarding other health benefits, one study investigating a postbiotic preparation of Lactobacillus gasseri OLL2809 observed preservation of natural killer cell activity and improvements in mood during strenuous exercise. Likewise, another study highlighted the ability of a postbiotic preparation of Lactococcus lactis JCM 5805 in improving antiviral responses and reducing the number of days with upper respiratory tract infection symptoms in athletes performing high-intensity training. Immunomodulatory and anti-inflammatory activities were also reported for the postbiotic preparation of Lacticaseibacillus paracasei MCC1849.   

    Significance

    Existing evidence suggests that postbiotics can be beneficial in improving mental health, reducing fatigue, and increasing the readiness of athletes across several weeks of exercise training. Thus, the current systematic review findings support the health and ergogenic benefits of postbiotic supplementation.

    Journal reference:

    • Kerksick, C. M., Moon, J. M., & Jager, R. (2024). It’s Dead! Can Postbiotics Really Help Performance and Recovery? A Systematic Review. Nutrients. doi:10.3390/nu16050720

    [ad_2]

    Source link

  • COVID-19 exposes deep-rooted structural inequities affecting vaccine uptake among ACB groups

    COVID-19 exposes deep-rooted structural inequities affecting vaccine uptake among ACB groups

    [ad_1]

    In a recent review published in Vaccines, researchers explored the influence of poor vaccination uptake among African, Caribbean, and Black (ACB) communities on public health in high-income nations.

    Study: Understanding Low Vaccine Uptake in the Context of Public Health in High-Income Countries: A Scoping Review. Image Credit: SeventyFour/Shutterstock.comStudy: Understanding Low Vaccine Uptake in the Context of Public Health in High-Income Countries: A Scoping Review. Image Credit: SeventyFour/Shutterstock.com

    Background

    The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has resulted in a massive vaccination drive; however, ACB communities have experienced significant adverse consequences and are unwilling to get the vaccine.

    These communities are at risk due to health disparities, such as the greater prevalence of SARS-CoV-2 infections and hospitalizations. These imbalances significantly impact the social determinants of health (SDOH), and vaccine hesitancy can lead to delayed or uncertain immunization.

    Global vaccination uptake has fallen; therefore, public health initiatives must adapt to present conditions and plan for future epidemics.

    About the review

    In the present review, researchers explored the variables contributing to poor vaccination uptake by ACB individuals, emphasizing healthcare in developed nations.

    They sought to find current data sources, map the evidence, identify research gaps, and identify existing treatments for increasing vaccination uptake in the study population.

    The team searched the Cochrane Central Register of Controlled Trials, Embase, MEDLINE, APA PsycInfo, CINAHL, Web of Science, Open Science Framework, and the Allied and Complimentary Medicine databases.

    They followed the Joanna Briggs Institute (JBI) model, supplemented by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping literature reviews (PRISMA-ScR). They included articles published in English or French between 2020 and July 19, 2022.

    The researchers performed the data search using the population, concept, and context (PCC) model to identify records discussing vaccine uptake among ACB residents of high-income nations, as defined by the World Bank.

    Evidence sources included primary studies, secondary research, abstracts, posters, conference proceedings, reports, and commentaries.

    Two researchers screened the data independently, and a third researcher resolved disagreements. The team used the social determinants of health (SDOH) method, the socioeconomic model (SEM), and thematic mapping (TM) to analyze and interpret the data.

    TM phases included individual-level, intra- and inter-group analyses to generate descriptive, analytical, and primary themes.

    Results

    Initially, the team identified 9,378 records, from which they removed 4246 duplicates. After title and abstract screening, they excluded 2,746 records.

    Of the remaining 2,386 records undergoing full-text screening, 60 eligible records were analyzed, including 24 quantitative, ten qualitative, 19 commentary records, and seven mixed-method records. Most records were from the United Kingdom, Canada, and the United States.

    Analysis performed via thematic mapping highlighted four primary themes: (i) inequities and racism, (ii) behaviors and sentiments, (iii) communication and knowledge, and (iv) influence and engagement.

    Inequities and racism in the healthcare system originate from mistrust, racial burden, and institutional impediments to access. Vaccine hesitancy (VH) is associated with increased rates of unwillingness to receive vaccinations, thereby perpetuating health inequities in black communities.

    The demographics of individuals exhibiting vaccine hesitancy reflect societal determinants of health, such as age, housing instability, poor income, and low education.

    Black vaccination starting in the United States is lower among immigrants from other countries, with the Americas and Caribbean Islands having a lower incidence than Africa.

    Factors like willingness, vaccination views, life events, and vaccine confidence determine vaccine uptake. Key causes include a lack of vaccination requirements, religious and political opinions, abuse, mortality exposure, and prior diseases.

    Mistreatment, exposure to mortality, and past diseases exemplify lived experiences. Vaccine confidence encompasses skepticism, timeliness, novelty, side effects, effectiveness, and safety.

    Black individuals are more likely to be vaccinated because of their existing health or their view that immunizations are the incorrect strategy.

    Vaccine hesitation might be due to a desire to protect oneself, a need for school or a job, or a desire to avoid infection. To lower vaccination uptake and COVID-19 infections, the government and healthcare institutions must address these variables.

    The lack of knowledge, disinformation, and misunderstandings in black communities all contribute to vaccination hesitation. Black parents are actively looking for information about kid vaccines, but the highest barrier is a lack of research on the short- and long-term impacts.

    Education, confidence in vaccine information, and open communication are critical for increasing immunization. Addressing distrust can boost vaccine confidence and intentions, while customizing messages to target populations can encourage immunization. Racism and prejudice, which serve as structural impediments to fair health care, must be addressed through culturally responsive techniques.

    Conclusion

    The review findings showed that ACB populations had lower vaccination uptake than high-income nations. Complacency, discomfort, and a lack of confidence are factors that contribute to vaccination reluctance, which past and contemporary racism and prejudice cannot entirely explain.

    The issue is complicated, encompassing knowledge and psychological, economic, and organizational constraints contributing to structural injustices. High-income nations should collect race-specific data for targeted treatments and increase the number of ACB participants in vaccine studies to boost vaccination trust.

    [ad_2]

    Source link

  • CUNY and Pfizer launch new project to track acute respiratory infections across the United States

    CUNY and Pfizer launch new project to track acute respiratory infections across the United States

    [ad_1]

    The City University of New York (CUNY) Institute for Implementation Science in Population Health (ISPH) and the CUNY Graduate School of Public Health and Health Policy (CUNY SPH), in collaboration with Pfizer, are initiating a critical two-year prospective epidemiologic study in the spring of 2024 to track acute respiratory infections across the United States.

    Project PROTECTS (Prospective Respiratory Outcomes from Tracking and Evaluating Community-based TeSting) builds on the pivotal CHASING COVID Cohort Study, which has monitored SARS-CoV-2 infection rates and associated risk factors through questionnaires and at-home serological testing since March 2020. The cohort’s participants have shown remarkable commitment, with the study recently concluding its 22nd questionnaire and fourth round of serological testing. “The sustained engagement of CHASING COVID Cohort Study participants has made the cohort one of the most enduring and thorough community-based studies of the SARS-CoV-2 pandemic, and represents an invaluable resource for ongoing scientific inquiry,” says CUNY SPH Distinguished Professor of Epidemiology Denis Nash, who is also the principal investigator of the study.

    This new project will harness both at-home rapid and PCR tests to investigate the incidence and symptom severity of several major respiratory viruses (SARS-CoV-2, RSV, influenza A, and influenza B), and characterize the performance of a new at-home multi-pathogen rapid test. “The study will address significant gaps in our understanding of the prolonged effects of these viruses on daily life, in the context of existing vaccines, background immunity, and treatments,” says Nash. The study will use a single rapid test for four different viruses that is currently in the research pipeline and not yet available to providers or patients.

    To achieve study aims, Project PROTECTS aims to enroll up to 6,000 participants, starting with individuals who were engaged in the CHASING COVID cohort. Participants will complete quarterly questionnaires on existing symptoms, health status, quality of life, occupational activities, vaccination history, past respiratory illnesses, and healthcare utilization using a study-specific web platform and mobile app.

    When participants exhibit symptoms of an acute respiratory infection, they will self-administer the multi-pathogen rapid test designed to test for all four respiratory viruses. It is administered in the same way as at-home SARS-CoV-2 tests. However, it simultaneously tests for SARS-CoV-2, RSV, influenza A, and influenza B, and can also detect co-infections. Those who test positive for one or more pathogens will complete questionnaires over the ensuing six months, with additional measures detailing symptoms, healthcare engagements and treatments, and new clinical diagnoses.

    The findings are expected to be pivotal in shaping future public health strategies and interventions to mitigate the impact of severe respiratory viruses on population health outcomes.”


    Denis Nash, CUNY SPH Distinguished Professor of Epidemiology

    Source:

    CUNY Graduate School of Public Health and Health Policy

    [ad_2]

    Source link

  • COVID-19 linked to long-lasting cognitive deficits, study finds

    COVID-19 linked to long-lasting cognitive deficits, study finds

    [ad_1]

    In a recent study published in the New England Journal of Medicine, researchers assessed cognitive functioning among adults with varying levels of persistence of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in England.

    Their results suggest that COVID-19 is associated with measurable cognitive deficits, which may persist in the long term.

    Study: Cognition and Memory after Covid-19 in a Large Community Sample. Image Credit: Berit Kessler / ShutterstockStudy: Cognition and Memory after Covid-19 in a Large Community Sample. Image Credit: Berit Kessler / Shutterstock

    Background

    The first documented cases of ‘brain fog,’ with symptoms such as poor memory, impaired concentration, and difficulty thinking, emerged as early as 2020, indicating that COVID-19 could have long-term cognitive impacts.

    Though the phenomenon is well-known, what is lacking is information on how it may persist and which aspects of cognitive functioning are most affected.

    About the study

    In this study, researchers hypothesized that cognitive deficits after the onset of COVID-19 should be quantifiable and associated with covariates related to illness severity and duration.

    Their second hypothesis was that individuals with prolonged COVID-19 symptoms should show more observable memory and executive function impairment, including brain fog and poor memory.

    They conducted a cohort-based study tracking the prevalence of SARS-CoV-2 infection among 3,099,386 individuals aged over 18 years. Of these, 800,000 people were invited to complete a cognitive assessment and follow-up survey.

    To be included, they should have received a positive result on a SARS-CoV-2 diagnostic test or suspected that they had COVID-19 and experienced symptoms for 12 weeks or more. Additionally, unvaccinated people with SARS-CoV-2 immunoglobulin-G antibodies and other randomly selected people from the full sample were included.

    The cognitive assessment tested immediate and spatial working memory, verbal analogical reasoning, two-dimensional mental manipulation, spatial planning, word definitions, delayed memory, and information sampling. For each domain, participants were scored on accuracy; secondary information was collected on types of errors and response times.

    Individuals were categorized into six groups based on SARS-CoV-2 duration. The first category included those who had never experienced an infection or had an unconfirmed one; all other categories required a positive test result.

    People in the second category had asymptomatic infections, those in the third had short COVID-19 that resolved in four weeks or less, and those in the fourth had symptoms that resolved in less than 12 weeks. To be in the fifth category, individuals had symptoms that persisted for more than 12 weeks; those in the sixth had persistent symptoms continuing until the cognitive assessments.

    Researchers assessed nonresponse bias to examine which factors were associated with accessing and completing the cognitive assessment. Linear regressions, factor analysis, and propensity-score matching (PSM) were used to analyze the data. Sensitivity analyses were also conducted to test the validity and robustness of the results.

    Findings

    Of the 800,000 people invited to participate, 34.6% completed the questionnaire, with 141,583 completing at least one cognitive testing task and 112,964 completing all eight.

    Among individuals infected with SARS-CoV-2 once, being infected earlier during the pandemic was associated with greater decreases in the overall cognitive score compared to those infected later. However, the gap narrowed after adjusting for the severity of the illness.

    On average, people who were ill for longer, were hospitalized, or were infected early on in the pandemic had lower overall cognitive scores than those who had never had COVID-19.

    Multivariate regression results indicated that people infected during the initial stages (when the original virus or alpha variant dominated) showed higher cognitive functioning decreases than those infected with the alpha or omicron variants.

    Similarly, greater decreases were seen in people with persistent and unresolved symptoms compared to those who never had COVID-19 and among people who were hospitalized compared to those who were not.

    The PSM analysis showed similar trends; cognitive advantages were observed based on vaccination status, with people who received two or more doses performing best. There was, however, no significant difference based on which vaccine was taken.

    Conclusions

    This large-sample community-based study suggests that COVID-19 may be associated with long-term and quantifiable cognitive deficits. However, people infected with more recent variants may experience more negligible effects on cognitive functioning.

    This could be because earlier strains of SARS-CoV-2 were dominant at a time when effective treatments were not available, and the health system faced heavy burdens. Repeated infections do not appear to have any effect, but vaccination (particularly two or more doses) may provide small cognitive advantages.

    Limitations of this study include the possibility of participant self-selection bias and reliance on self-reported data. Certain groups were overrepresented in the sample, including White persons and women; younger people and certain underprivileged groups were underrepresented.

    Further studies are required to provide information on the longer-term implications of these findings.

    Journal reference:

    • Cognition and memory after Covid-19 in a large community sample. Hampshire, A., Azor, A., Atchison, C., Trender, W., Hellyer, P.J., Giunchiglia, V., Husain, M., Cooke, G.S., Cooper, E., Lound, A., Donnelly, C.A., Chadeau-Hyam, M., Ward, H., Elliott, P. New England Journal of Medicine (2024). DOI: 10.1056/NEJMoa2311330, https://www.nejm.org/doi/10.1056/NEJMoa2311330

    [ad_2]

    Source link

  • How long do cognitive and memory dysfunctions persist after SARS-CoV-2 infection?

    How long do cognitive and memory dysfunctions persist after SARS-CoV-2 infection?

    [ad_1]

    A recent New England Journal of Medicine study assessed whether cognitive deficits can be measured after severe acute respiratory syndrome (SARS-CoV-2) infection, the causal agent of the coronavirus disease 2019 (COVID-19) pandemic.

    This study further explored the period for which these symptoms persist.

    Study: Cognition and Memory after Covid-19 in a Large Community Sample. Image Credit: Orawan Pattarawimonchai/Shutterstock.comStudy: Cognition and Memory after Covid-19 in a Large Community Sample. Image Credit: Orawan Pattarawimonchai/Shutterstock.com

    Background

    Brain fog is the common name for problems associated with thinking, concentrating, or memory. It has been observed frequently in patients recovered from COVID-19, but there is a dearth of objective data on cognitive performance.

    Furthermore, it is not clear which cognitive functions are most vulnerable and how long such deficits persist.

    About the study

    The primary hypothesis in this observational study was that cognitive deficits after COVID-19 were measurable and scalable regarding illness severity and duration.

    The secondary hypothesis was that objective impairments in memory and executive functions would be noted in patients showing prolonged symptoms.

    These hypotheses were tested using data from the Real-Time Assessment of Community Transmission (REACT) cohort in England.

    Eight hundred thousand adults were invited to complete an online assessment of cognitive function.

    Across eight tasks, a global cognitive score was estimated. These tasks helped test immediate memory, verbal analogical reasoning, two-dimensional mental manipulation, verbal analogical reasoning, spatial working memory, word definitions, delayed memory, spatial planning, and information sampling.

    Individuals who were invited to participate in this study were SARS-CoV-2 test positive or with persistent COVID-19 symptoms for at least 12 weeks.

    The eligible participants were categorized into six groups based on the duration of SARS-CoV-2 infection.

    The categories were defined as follows:

    • Category 1: No infection with SARS-CoV-2 detected.
    • Category 2: Infected with SARS-CoV-2, but no symptoms developed (asymptomatic infection).
    • Category 3: Experienced a brief infection period, with symptoms lasting less than four weeks.
    • Category 4: The period of infection lasted between 4 and 12 weeks.
    • Category 5: Symptoms were resolved at least 12 weeks after the onset of the infection.
    • Category 6: Symptoms persisted for more than 12 weeks after the infection began and were present during the cognitive assessment.

    Study findings

    This community-based study noted that COVID-19 and long-term objectively measurable cognitive deficits were associated with each other.

    The difference in the cognitive score between the no-COVID group and the group of participants whose symptoms had resolved was small. The difference was, however, large for participants who experienced unresolved symptoms.

    The probability of task performance was below the cut-off point in the case of moderate impairment.

    Relative to the no-COVID group, larger cognitive differences were noted in the group where ICU admission was needed. This finding is consistent with the ones documented in previous studies where medium-to-large-scale cognitive deficits were observed in patients who were hospitalized in a critical care unit.

    It was noted that with the progression of the pandemic, the association between cognitive deficits and COVID-19 attenuated.

    Smaller cognitive declines were noted among those infected with newer variants, compared to the original strain or the Alpha strain. Individuals who had received two or more vaccine doses were seen to have a small cognitive advantage.

    A progressive decline in cognitive deficits was observed among those infected during the pandemic’s first wave.

    The observation that patients whose persistent symptoms had resolved had experienced global cognitive deficits similar in nature to patients with shorter-duration symptoms is indicative of the fact that individuals with persistent symptoms could experience some degree of cognitive improvement once symptoms resolve.

    The executive, memory, and reasoning tasks were the most sensitive to COVID-19. The performance was dependent on hospitalization and illness duration.

    The scores were also weakly correlated with recent brain fog or poor memory. The results documented here validated the associations between mood swings, fatigue, and cognitive deficits, besides a variety of other symptoms.

    Limitations of the study

    A key limitation centers around subjective reporting to identify patients with persistent symptoms.

    Linking these results to the literature is difficult owing to the lack of definitive criteria for post–COVID-19 syndromes. Furthermore, causality could not be inferred owing to the observational nature of the data.

    The global cognitive score calculation adjusted for demographic characteristics and pre-existing health conditions. However, some residual confounding could have remained due to the observational nature of the data.

    To mitigate this bias, the propensity score matching method was used to show a highly consistent pattern of results.

    As with any study requiring active participant engagement, self-selection bias could not be ruled out.

    Patients with the most severe cognitive impairment may not have been willing or able to take a cognitive assessment.

    Additionally, some groups were less representative compared to the base population. Individuals from deprived backgrounds and younger persons were underrepresented.

    [ad_2]

    Source link

  • Only 9% of older Americans vaccinated against RSV, study finds

    Only 9% of older Americans vaccinated against RSV, study finds

    [ad_1]

    A new study from the Texas A&M University School of Public Health found that only 9 percent of older Americans had been vaccinated against respiratory syncytial virus (RSV) prior to this fall and winter, despite the threat of increased rates of hospitalization and deaths nationwide from the virus.

    RSV-;along with COVID-19 and influenza-;form the current ‘tripledemic’ found across the United States this fall and winter. While the elderly, as well as the very young and those with chronic health conditions, typically are affected more than others, the good news is that vaccines now are available for all three of these respiratory viruses.”

    Simon Haeder, PhD, the study’s author

    The study, one of the first to address seniors and RSV, was published in Health Affairs Scholar. It asked 1,345 Americans over the age of 60 about their current RSV vaccination status and their intention to get the vaccine. Although RSV usually causes mild, cold-like symptoms that last a week or two, it can also lead to serious illness. According to the Centers for Disease Control and Prevention (CDC), 60,000 to 160,000 seniors in the United States are hospitalized with RSV each year, and 6,000 to 10,000 ultimately die from the infection.

    The study found that men were more likely to be vaccinated against RSV than women, and that those who were vaccinated had higher levels of concern about the disease, believed they were at greater risk for getting the disease, believed that vaccines were safe and important, and had higher levels of trust in health institutions.

    Of the 91 percent of seniors who were unvaccinated against RSV, 42 percent said they planned to get the vaccination. Respondents who were vaccine hesitant reported that they did not need the vaccine, lacked information about the vaccine and had concerns about its side effects and safety.

    “Although the vaccines are 83 percent to 89 percent effective in preventing lung infections, the CDC did not officially recommend them this year, which may have also been a factor,” Haeder said. “In addition, vaccine hesitancy is growing worldwide in response to COVID-19.”

    The likely results will be more illnesses, hospitalizations and deaths among the vaccine hesitant, especially among the very young, elderly and those who have chronic health conditions, Haeder said.

    Haeder’s study is the latest in a series of studies assessing vaccination hesitancy in the United States. Previous studies have looked at parents’ intention to seek out vaccinations against COVID-19, influenza and RSV for their children, as well as adults’ intention to seek out vaccinations against COVID-19. Haeder also previously assessed vaccination hesitancy amongst pet owners.

    Haeder said vaccine hesitancy could be addressed through policies that focus on the potential benefits of vaccination and the potential risks of not being vaccinated, along with programs-;especially those tailored for women-;that debunk misleading claims about RSV and its vaccines.

    “Not only will the unvaccinated place a great burden on the health care system, but their illnesses could have been prevented or mitigated by vaccinations,” Haeder said. “The costs to society will be large and will affect society as a whole.”

    Source:

    Journal reference:

    Haeder, S. F. (2024). U.S. Seniors’ Intention to Vaccinate Against RSV in Fall and Winter 2023. Health Affairs Scholar. doi.org/10.1093/haschl/qxae003.

    [ad_2]

    Source link

  • Latest COVID-19 booster halves risk of moderate or severe disease in adults

    Latest COVID-19 booster halves risk of moderate or severe disease in adults

    [ad_1]

    The most recent COVID-19 booster shot reduces adults’ risk of moderate or severe COVID by more than half, according to a new nationwide data study from September 2023 through January 2024, a period of JN.1 variant dominance.

    The new study is one of the first to evaluate protection provided by the updated shot against COVID-19-associated emergency department and urgent care visits (markers for moderate disease) and against hospitalizations (a marker for severe disease), in individuals 18 and older, due to JN.1, the most recently predominant strain of COVID.

    Halving your risk of needing to visit an E.D. or urgent care center or to be treated in the hospital for COVID is significant. As an informatician I want to highlight that the data we analyzed came from different populations and geographic locations, adults of all ages and the most recent COVID strain. This analysis strongly supports the benefit of getting a booster shot and as a clinician, I encourage my patients to do so.”


    Shaun Grannis, M.D., M.S., study co-author, Regenstrief Institute vice president for data and analytics and professor at Indiana University School of Medicine

    “These are encouraging findings,” said study co-author Brian Dixon, PhD, MPA, interim director of Regenstrief Institute’s Clem McDonald Center for Biomedical Informatics and professor at Indiana University Richard M. Fairbanks School of Public Health. “These estimates of vaccine effectiveness are what we would expect for an annual booster designed for an endemic virus that continues to evolve. We looked at a longer time period than similar studies in Europe, and we found good performance. Yet we do need to be alert to the presumed waning of the updated booster’s effectiveness, which we have seen in earlier COVID-19 vaccines. Americans should expect the CDC to recommend future boosters, likely on an annual schedule.”

    These findings of protection against moderate and severe disease provided by the booster in this large study are consistent with those of an earlier, small scale study of individuals seen for testing at a pharmacy. That study did not include hospitalized patients.

    The authors of the new study, co-authored by Drs. Grannis and Dixon, concluded, “In this analysis of updated COVID-19 VE [vaccine effectiveness], receipt of an updated COVID-19 vaccine dose provided protection against COVID-19-associated ED/UC [emergency department/critical care] visits and hospitalizations among immunocompetent adults. CDC will continue monitoring VE of updated COVID-19 vaccines. All adults should stay up to date with recommended COVID-19 vaccines, including receiving a dose of updated vaccine.”

    Source:

    Journal reference:

    DeCuir, J., et al. (2024) Interim Effectiveness of Updated 2023–2024 (Monovalent XBB.1.5) COVID-19 Vaccines Against COVID-19–Associated Emergency Department and Urgent Care Encounters and Hospitalization Among Immunocompetent Adults Aged ≥18 Years — VISION and IVY Networks, September 2023–January 2024. Morbidity and Mortality Report (MMWR). doi.org/10.15585/mmwr.mm7308a5.

    [ad_2]

    Source link

  • Long-term smell and taste loss

    Long-term smell and taste loss

    [ad_1]

    A recent study published in Life investigates the mechanisms responsible for severe olfactory dysfunction (OD) and gustatory dysfunction (GD) following recovery from the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.

    Study: Persistent Olfactory and Taste Dysfunction after COVID-19. Image Credit: DimaBerlin / Shutterstock.com Study: Persistent Olfactory and Taste Dysfunction after COVID-19. Image Credit: DimaBerlin / Shutterstock.com

    Background

    SARS-CoV-2 is the causal agent of the coronavirus disease 2019 (COVID-19). A sudden loss of smell or taste is one of the most common symptoms of SARS-CoV-2 infection.

    Typically, OD and GD occur in the early phase of the infection, which has led these symptoms to be used as a screening tool for COVID-19. Both OD and GD occur primarily among young patients and are independent of gender.

    COVID-19 patients with OD often experience a spontaneous return of their sense of smell to pre-symptomatic levels within one month of infection. However, between 7-20% of COVID-19 patients report prolonged OD, even after other symptoms have resolved.

    Mechanistically, patients with severe nasal and sinus symptoms undergo swelling of the mucous membranes of the olfactory cleft, which increases mucus secretion. This increase in mucus causes a mechanical blockage to odor molecules, manifesting as conductive OD. Infiltration of viral particles into the non-neural cells of the olfactory epithelium also induces significant immune responses.

    In the context of immune responses to viral infiltration into olfactory epithelium, pro-inflammatory cytokines such as interleukin 1 β (IL-1β) and tumor necrosis factor α (TNF- α) are released. The impaired non-neural cells subsequently disrupt the connection between nerve cells and sensory OD, which inhibits the transfer of olfactory stimuli to the brain.

    Importantly, the precise mechanism of action on the penetration of SARS-CoV-2 into the central nervous system remains unclear. One possible mechanism could be the direct penetration of SARS-CoV-2 into the cerebrospinal fluid from non-neural cells of the olfactory epithelium.

    The penetration of SARS-CoV-2 into the olfactory neuroepithelium causing sensorineural OD has been well documented. In this context, the spike (S) protein of SARS-CoV-2 binds to the angiotensin-converting-enzyme-2 (ACE2) receptor, which triggers the synthesis of the transmembrane serine protease 2 (TMPRSS2), thereby causing membrane fusion.

    To date, few studies have elucidated the mechanism that underlies the manifestation of GD due to COVID-19.

    About the study

    The current prospective and single-center study involved a subjective and physical examination of patients. Study participants also underwent multiple olfactory and gustatory tests, such as the Sniffin’ Sticks Test (SST) and Taste Strips Test (TS).

    A total of 81 participants were recruited, including 16 men and 65 women between 12 and 73 years of age. All participants experienced OD due to COVID-19, which persisted for at least one month after the resolution of other acute symptoms.

    Study findings

    The study participants experienced persistent OD or GD (OGD) with durations ranging between one and 25 months.

    Few clinical facilities offer help to patients with persistent OGD following recovery from COVID-19. This could be because clinicians are still developing their knowledge regarding long-term COVID and formulating strategies to combat the condition. Additionally, patients often seek treatment for OD only after resolving more serious symptoms.

    The degree of damage in the olfactory cells by SARS-CoV-2 penetration dictates the duration of OD. For conductive disorders that occur in most infected individuals, the sense of smell improves after a reduction in acute inflammation of the nasal mucosa. Patients with damaged olfactory cells exhibit persistent OD, as neurons take longer to recover and re-establish adequate intercellular connections.

    About 64% of the study participants had hyposmia, and 22% had functional anosmia. SST scores revealed that the participants scored lowest on the threshold part of the test. The SST score of other parts concerning discrimination and identification of odor revealed that patients could sense intense smell correctly.

    SST scores significantly depend on the function of the olfactory epithelium, which suggests that post-COVID-19 OD is predominantly associated with damage in peripheral olfactory due to acute immune responses. More specifically, the cytokine storm leads to leukocytic infiltration and disrupts olfactory epithelial cells, including stem cells.

    There was no difference in recognizing odorants that stimulate only the olfactory nerve and those that trigger the trigeminal nerve, such as mint and lemon. Interestingly, some participants with subjective ODs scored within a normal range on the SST test. 

    Around 17% of participants reported abnormal taste. The best-recognized taste was sweet, followed by salty. Only bitter taste was marginally correlated with TTS and TS scores.

    Conclusions

    The findings provide important insights into the relationship between OD and SARS-CoV-2 infection. It is possible that the relationship between OD and COVID-19 is more peripheral than central; therefore, clinicians must pay close attention to the condition of the nasal mucosa and provide better information to patients about good nasal hygiene that can help alleviate the condition.

    Journal reference:

    • Buksinska, M., Skarzynski, P. H., Raj-Koziak, D., et al. (2024) Persistent Olfactory and Taste Dysfunction after COVID-19. Life 14(3); 317. doi:10.3390/life14030317.

    [ad_2]

    Source link