Coronavirus Tidbits #189 4/24/22

Announcements:

First, there is now a Resources Page here for the most commonly asked questions I'm getting.

Happy to continue to answer your questions/concerns as best I can, so don't be shy about that.

New posts:

What’s Causing A Sudden Outbreak Of Hepatitis In Kids In Europe And The US?

https://www.forbes.com/sites/judystone/2022/04/16/whats-causing-a-sudden-outbreak-of-hepatitis-in-kids-in-europe-and-the-us/

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Experts Decry CDC's Long Pause on Tropical Disease Testing

The CDC stopped testing for parasites last September without telling anyone, later saying it was to "make improvements." Testing for some can't readily be done elsewhere--especially hurting poor people of color and immigrants, most likely to be infected. #Chagas #leishmania

https://www.medscape.com/viewarticle/972413

News 

COVID-19 pneumonia increases dementia risk

A new study from the from the University of Missouri School of Medicine and MU Health Care shows patients hospitalized with COVID-19 pneumonia have a higher risk of developing dementia than those with other types of pneumonia.

A team of MU researchers pulled Cerner Real World Data from 1.4 billion medical encounters prior to July 31, 2021. They selected patients hospitalized with pneumonia for more than 24 hours. Among 10,403 patients with COVID-19 pneumonia, 312 (3%) developed new onset dementia after recovering, compared to 263 (2.5%) of the 10,403 patients with other types of pneumonia diagnosed with dementia.

“The risk of new onset dementia was more common in COVID-19 pneumonia patients over the age of 70 in our study,” said lead researcher Adnan I. Qureshi, MD, a professor of clinical neurology at the MU School of Medicine. “The type of dementia seen in survivors of COVID-19 infection mainly affects memory, ability to perform everyday tasks and self-regulation. Language and awareness of time and location remained relatively preserved.”

The median time interval between infection and dementia diagnosis was 182 days for COVID-19 patients. The study only included new onset dementia associated with hospital admission during a short follow-up period. Qureshi said further study over longer periods of time would provide a more complete picture and may help to determine the underlying reasons why COVID-19 pneumonia might increase dementia risk.

http://outbreaknewstoday.com/covid-19-pneumonia-increases-dementia-risk-79242/

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Long-term lung abnormalities common 1 year after COVID-19 pneumonia

Long-term CT abnormalities were common up to 1 year after COVID-19 pneumonia in a study published in Radiology.

Researchers performed a secondary analysis of CovILD, a prospective, multicenter, observational cohort study, conducted from April to August 2020. The study evaluated pulmonary abnormalities on chest CT at 2, 3 and 6 months and 1 year after COVID-19 symptoms in 142 adults who had mild to severe COVID-19. Researchers graded pulmonary CT findings for each lung lobe and assessed associations between demographic and clinical factors with CT abnormalities at 1 year. The study was conducted in Austria.

Overall, 91 participants from the CovILD study (mean age, 59 years; 38% women) had 1-year follow-up CT data and were included in the secondary analysis.

“More than half of the hospitalized participants still have permanent lung changes 1 year after COVID-19,” Schwabl told Healio.

Among the 54% of participants with CT abnormalities 1 year later, 34% had subtle subpleural reticulation, ground-glass opacities or both and 20% had extensive ground-glass opacities, reticulations, bronchial dilation and/or microcystic changes in the lung.

https://www.healio.com/news/pulmonology/20220415/longterm-ct-abnormalities-common-1-year-after-covid19-pneumonia

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Global data reveal half may have long COVID 4 months on

Worldwide, 49% of COVID-19 survivors reported persistent symptoms 4 months after diagnosis, estimates a meta-analysis of 31 studies published late last week in The Journal of Infectious Diseases.

University of Michigan researchers, who conducted a systematic review on Jul 5, 2021, also found the prevalence of long COVID at 1 month at 37%, while it was 25% at 2 months and 32% at 3 months. Fifty studies were identified in the review, and 41 were included in a quantitative synthesis, and 31 reporting overall prevalence were meta-analyzed.

The 50 studies included a total of 1,680,003 COVID-19 patients, including those who were hospitalized (67,161 patients from 22 studies), nonhospitalized (4,165 from 5 studies), and any COVID-19 patients, regardless of hospitalization status (1,608,677 from 23 studies).

Impact on health, workforce 'enormous'

Estimated global prevalence of long COVID was 43% (95% confidence interval [CI], 39% to 46%), although estimates ranged from 9% to 81%, which the study authors said may be attributable to differences in sex, region, study population, and follow-up.

Long COVID prevalence among hospitalized patients was 54% (95% CI, 44% to 63%), while it was 34% (95% CI, 25% to 46%) for outpatients.

Regionally, estimated pooled prevalence of lingering COVID-19 symptoms was 51% (95% CI, 37% to 65%) in Asia, 44% (95% CI, 32% to 56%) in Europe, 31% (95% CI, 21% to 43%) in North America, and 31% (95% CI, 22% to 43%) in the United States.

Worldwide, estimated prevalence of long COVID was 37% (95% CI, 26% to 49%) 1 month after diagnosis, 25% (95% CI, 15% to 38%) at 2 months, 32% (95% CI, 14% to 57%) at 3 months, and 49% (95% CI, 40% to 59%) at 4 months. The most common symptoms were fatigue (23%), followed by memory problems (14%), shortness of breath (13%), sleep problems (11%), and joint pain (10%).

Overall, the meta-analysis showed that a higher percentage of women reported long COVID symptoms than men (49% vs 37%, respectively) and that preexisting asthma was a predisposing factor for lingering symptoms. Risk factors identified in the studies that weren't meta-analyzed included severe initial illness, older age, and underlying conditions such as obesity and hypothyroidism.

Findings from the study show that the prevalence of long COVID is substantial, the health effects of infection seem to be prolonged, and the condition could stress the healthcare system, the researchers said.

"We recommend continued attention be focused on identifying patients at-risk of developing post COVID-19 condition and on quantifying duration of symptoms. With an estimated 200 million individuals affected, post COVID-19 condition's impact on population health and the labor force is enormous," they concluded.

"It is imperative that those affected are provided proper health, social, and economic protections."

https://www.cidrap.umn.edu/news-perspective/2022/04/global-data-reveal-half-may-have-long-covid-4-months

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At CDC's urging, Justice Department appeals judge’s decision to drop mask mandate

The Justice Department has appealed a federal judge’s decision that struck down the mask mandate on public transportation, the Washington Post reports, after CDC recommended the move. “It is CDC’s continuing assessment that at this time an order requiring masking in the indoor transportation corridor remains necessary for the public health,” the agency said late yesterday. “CDC believes this is a lawful order, well within CDC’s legal authority to protect public health.” The ruling in question was made on Monday by U.S. District Judge Kathryn Kimball Mizelle in Florida, who concluded that the mandate exceeded CDC’s statutory authority. Her decision blindsided the Biden administration and set off changes mid-flight on some airlines. The Justice Department on Tuesday had said that it would wait for CDC’s recommendation on whether to proceed with an appeal, which could tee up a battle at the Supreme Court.

https://mailchi.mp/statnews/tk-tncyc6de8v-615464?e=5c09ee46b1

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Diagnostics:

still an incredible, negligent last of testing.

Drugs and Vaccines:

CDC advisers air frustration over booster policy

Experts who advise the CDC met yesterday to discuss a thorny issue: Covid vaccine boosters, specifically the new policy to allow people 50 and older and people who are immunocompromised to get a second booster. By the end of the meeting — during which members of the Advisory Committee on Immunization Practices expressed frustration with the lack of clarity about the goal of the U.S. booster policy — it wasn’t entirely clear why people are being offered a second booster at this time. Data presented by CDC experts suggested the protection that immune-competent people have received from their primary series and first booster is holding up and the expected benefits from the fourth shots are modest at best. ACIP member Beth Bell raised concerns about “booster fatigue” and said offering another dose now could undercut confidence in vaccines that are working well at protecting people from severe Covid. The policy to offer the fourth doses was made without consulting ACIP.

https://mailchi.mp/statnews/tk-tncyc6de8v-615464?e=5c09ee46b1

Devices:

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Epidemiology/Infection control:

Coronavirus found in human feces up to 7 months after infection

COVID-19 is mainly known as a respiratory ailment, but a new study suggests the coronavirus can infect your intestinal tract for weeks and months after you've cleared the bug from your lungs.

In the study about 1 out of 7 COVID patients continued to shed the virus' genetic remnants in their feces at least four months after their initial diagnosis, long after they've stopped shedding the virus from their respiratory tract, researchers found.

This could explain why some COVID patients develop GI symptoms like abdominal pain, nausea, vomiting and diarrhea, said senior researcher Dr. Ami Bhatt, an associate professor of medicine and genetics at Stanford University.

"We found that people who had cleared their respiratory infection—meaning they were no longer testing positive for SARS-CoV-2 in their respiratory tract—were continuing to shed SARS-CoV-2 RNA in their feces," Bhatt said. "And those people in particular had a high incidence of GI symptoms."

A long-term infection of the gut also might contribute to long COVID symptoms in some people, Bhatt and her colleagues theorized.

"Long COVID could be the consequence of ongoing immune reaction to SARS-CoV-2, but it also could be that we have people who have persistent infections that are hiding out in niches other than the respiratory tract, like the GI tract," Bhatt said.

https://medicalxpress.com/news/2022-04-coronavirus-human-feces-months-infection.html

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Tips, general reading for public:

Ventilate.

Mask.

Vax.

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1. Wear a good fitting mask. See previous tweets. (1/)

4. Realize #COVIDisAirborne and wear the best masks. Filter indoor air.(4/)

Politics:

https://twitter.com/ASlavitt/status/1516392077638086658?s=20&t=Tk0tLkPFJM-FaUQWXKvKvg

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https://twitter.com/KHNews/status/1517132292883243008?s=20&t=Tk0tLkPFJM-FaUQWXKvKvg

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Abortion:

LGBT:

Voting:

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Jan 6:

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https://twitter.com/ryanjreilly/status/1516453362857824~ ~ ~257?s=20&t=Tk0tLkPFJM-FaUQWXKvKvg

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GOP:

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Texas:

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FL:

TN

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Ukraine:

Feel good du jour:

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https://twitter.com/buitengebieden_/status/1513049270047358976?s=20&t=Tk0tLkPFJM-FaUQWXKvKvg

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Comic relief:

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Perspective/Poem

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Bits of beauty:

Blackwater National Wildlife Refuge

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