Coronavirus Tidbits #283, Feb 25, 2024

Latest Biobot data shows U.S. COVID wastewater levels are rising again, and higher than they have ever been compared to the same date in previous years.

In other words, COVID levels are still high and taking longer to go down after this winter's peak. Keep taking precautions. pic.twitter.com/7DOQbX1QOu

— Dr. Lucky Tran (@luckytran) February 20, 2024

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Paxlovid use tied to 84% lower risk of hospital care

University of North Carolina–Chapel Hill investigators report today that COVID-19 hospitalization risk was reduced by 84% among Paxlovid (nirmatrelvir and ritonavir) recipients in a large, diverse healthcare system during January to August 2022, when the Omicron strain was dominant.

The study appears in the Journal of Antimicrobial Chemotherapy. Paxlovid is authorized for use in US patients 12 years and older at risk for developing severe outcomes from COVID-19 infections. In early clinical trials, the use of the antiviral drug was associated with a relative risk reduction of 89% of disease progression to severe illness.

https://www.cidrap.umn.edu/covid-19/paxlovid-use-tied-84-lower-risk-hospital-care

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Long Covid disparities in states:

 pediatric long COVID, which affects an estimated 5.8 million children.

According to the results of the new survey, West Virgnia has the highest long COVID prevalence of any state at 10.6% (95% CI, 9.5%-11.8%). The other six states with a prevalence higher than 8.8% were Alabama, Montana, North Dakota, Oklahoma, Tennessee and Wyoming.

https://www.healio.com/news/infectious-disease/20240216/cdc-identifies-states-with-highest-and-lowest-rates-of-long-covid

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New variant being watched:

The CDC announced last week that it's tracking a new variant of SARS-CoV-2 -- named BA.2.87.1 -- given its large number of changes in the spike protein.

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Missed cancers during the pandemic:

Annual cancer incidence fell almost 30% short of the expected rate from March through December 2020. The difference represented potentially 134,395 undiagnosed cancers during that period. ...Overall, rates of "screenable" cancers decreased by 13.9% versus expected rates.

https://www.medpagetoday.com/hematologyoncology/othercancers/108860?

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LongCovid linked to persistently high levels of inflammatory protein Gamma Interferon:

A potential biomarker and target for treatments

https://medicalxpress.com/news/2024-02-covid-linked-persistently-high-inflammatory.html

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⚠️#COVID19 Syst review & metaanalysis (10K): #SARSCoV2 in saliva (83%), feces (32%), semen (2%), vaginal secretion (3%), urine (4%) w/ viral culture pos in saliva, feces. Max viral persistence in feces (210d), semen (121d), saliva (112d), urine (77d) & vaginal (13d). #MedTwitter pic.twitter.com/2U3BP7ZUTA

— Tatiana Prowell, MD (@tmprowell) February 24, 2024

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Solving the puzzle of #LongCovid @ScienceMagazine today, @zalaly and I review what we know and what needs to be donehttps://t.co/nN50ke4Skx
w/ @ScienceVisuals @ashleymastin_
+ thanks @AldertonBiol for expert editing pic.twitter.com/XId9k0mQnr

— Eric Topol (@EricTopol) February 22, 2024

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Measles:

Now in AZ, New Orleans, and will blossom in Florida:

https://www.cidrap.umn.edu/measles/two-measles-cases-confirmed-new-orleans

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Florida Defies CDC Amid Measles Outbreak, Says Unvaccinated Kids Can Attend School

— CDC advises that unvaccinated students stay home from school for 3 weeks after exposure

Florida Surgeon General Joseph Ladapo, MD, PhD, [is a menace].

Note: Measles has airborne transmission and is highly infectious, with an R0 of 12-18, meaning that 1 measles case => 12-18 secondary cases.

A person with measles can pass along an infection before they develop a fever, cough, rash, or other signs of the illness. About one in five people with measles end up hospitalized, 1 in 10 develop ear infections that can lead to permanent hearing loss, and about one in 1,000 die from respiratory and neurological complications.

Curbing a 2018 outbreak in southern Washington with 72 cases cost about $2.3 millionopens in a new tab or window, in addition to $76,000 in medical costs, and an estimated $1 million in economic losses due to illness, quarantine, and caregiving.

from Amy Maxman, KFF, but also reported here: https://www.medpagetoday.com/infectiousdisease/generalinfectiousdisease/10887

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Lassa Fever:

Long neglected, Lassa fever is surging in West Africa. Researchers want to know why

Lassa fever kills far more people than Ebola does—10,000 or more a year, some researchers suspect, although no one knows for sure. ...

Confirmed cases, which numbered roughly 25 to 100 in previous outbreak years, reached 633, and 171 people died, including 45 health care workers.

Cases in Nigeria have continued to climb each year since then.

Most worrisome, cases are popping up outside the four known endemic countries: Nigeria, Sierra Leone, Guinea, and Liberia.

https://www.science.org/content/article/deadly-viral-illness-exploding-west-africa-researchers-are-scrambling-figure-out-why

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Guideline now recommends fecal microbiota transplant for the majority of recurrent C. diff patients

In the first comprehensive evidence-based guideline on the use of fecal microbiota-based therapies for gastrointestinal disease, the American Gastroenterological Association recommends fecal microbiota transplant (FMT) for most patients with recurrent Clostridioides difficile (C. diff) infection.

https://medicalxpress.com/news/2024-02-guideline-fecal-microbiota-transplant-majority.html