Vaccines not linked to menstrual changes; COVID, flu shots can go together

By Nancy Lapid

(Reuters) – The following is a summary of some recent studies on COVID-19. They include research that warrants further study to corroborate the findings and that has yet to be certified by peer review.

No link seen between vaccines and menstrual changes

Many women have reported noticing changes in their menstrual cycle after being vaccinated against COVID-19 but a new study of 1,273 women in the UK found no correlation, according to a report posted on Monday on medRxiv ahead of peer review. The women in the study kept careful records of their cycles and their vaccination dates. “We were unable to detect strong signals to support the idea” that COVID-19 vaccines are linked to changes in timing or flow of women’s periods, said Victoria Male from Imperial College London. It is possible that larger studies, or studies in other countries, might find links, she said. “It is important to note that most people who report such a change following vaccination find that their period returns to normal the following cycle.” Other studies have found no evidence that the vaccines affect female fertility, Male added.

Safe to get COVID-19 vaccine, flu shot together

It is safe to administer COVID-19 vaccines and flu vaccines to patients at the same time, and doing so might increase vaccination rates, according to a report published on Thursday in The Lancet. Researchers randomly assigned 697 adult volunteers to receive their second dose of either the mRNA vaccine from Pfizer/BioNTech or the viral-vector vaccine from AstraZeneca/Oxford, along with one of three influenza vaccines for the 2020-2021 season (FluAd or Flucelvax from Seqirus UK or Flublok from Sanofi) or a placebo. Most reactions to the shots were mild or moderate, and antibody responses to the vaccines were not adversely affected by getting two shots at once, the study found. Giving both vaccines at a single appointment “should reduce the burden on health-care services for vaccine delivery, allowing for timely vaccine administration and protection from COVID-19 and influenza for those in need,” the research team concluded.

Lung cancer patients respond well to COVID-19 vaccines

Lung cancer patients may get good protection from mRNA COVID-19 vaccines even while undergoing treatments that suppress the immune system, a small study suggests. From January through July this year, researchers in France administered the vaccine from Pfizer/BioNTech to 306 lung cancer patients, 70% of whom had recently received immunosuppressive therapies that impair the body’s ability to respond to vaccines. Patients with COVID-19 antibodies from a previous infection received only one dose; most patients, however, received both doses, according to a paper released on Monday and scheduled for publication in the Journal of Thoracic Oncology. About 10% of the patients failed to develop antibodies in response to the first two doses and received a third dose, which successfully induced antibodies in all but three individuals who also had blood disorders known to impair the effect of the vaccines. The researchers noted that before vaccines, the death rate among lung cancer patients who developed COVID-19 was 30%. In this seven-month study, only eight patients, or 2.6% of the total, developed mild cases of COVID-19. Because the study was small and not randomized, the investigators called for more research to confirm their findings.

(Reporting by Nancy Lapid; Editing by Tiffany Wu)

COVID-19 patients still have symptoms 6 months later; interferon may be helpful treatment after all

By Nancy Lapid

(Reuters) – The following is a roundup of some of the latest scientific studies on the novel coronavirus and efforts to find treatments and vaccines for COVID-19, the illness caused by the virus.

Half a year later, COVID-19 patients still have symptoms

Most patients hospitalized with COVID-19 have at least one symptom six months after falling ill, according to findings from a study in Wuhan, China, where the novel coronavirus first emerged in late 2019. Doctors there tracked 1,733 patients who were diagnosed and hospitalized between January, 2020 and May. Six months later, 76% had at least one symptom including fatigue or muscle weakness (seen in 63%), sleep difficulties and anxiety or depression. Most of those who had been severely ill had ongoing lung problems and chest abnormalities that could indicate organ damage, while 13% of patients whose kidneys functioned normally in the hospital went on to develop kidney problems later, researchers reported on Friday in The Lancet. “We are only beginning to understand” some of the long-term effects of COVID-19, study coauthor Bin Cao from the China-Japan Friendship Hospital in Beijing said in a statement. “Our analysis indicates that most patients continue to live with at least some of the effects of the virus after leaving hospital,” highlighting the need for post-discharge care.

Interferon boosts proteins that deny entry to coronavirus

An experimental inhaled form of interferon being tested for treating hospitalized COVID-19 patients may not have a limitation researchers had feared. A potential problem with interferon is that it increases levels of a protein called ACE2, which the new coronavirus uses as a gateway into cells. In test tube experiments, researchers looked at cells that line the path from the nose into the lungs and discovered there are actually two forms of ACE2 – the well known one and a short form that lacks the entryway used by the virus. Interferon increases the short form of ACE2 but not the longer form, they found, which means it does not appear to boost entry points for the virus. “We were excited to discover a new form of ACE2,” Dr. Jane Lucas of the University of Southampton, who co-led the study reported on Monday in Nature Genetics, said in a statement. “We believe this may have important implications for managing COVID-19 infection.” An inhaled interferon from Synairgen Plc is being tested in late-stage trials.

Saliva viral load improves prediction of COVID-19 severity

The amount of the new coronavirus in saliva might help guide doctors’ care of patients because it is a better predictor of disease course than viral load in swab samples obtained from the nose and the back of the throat, researchers said. They studied 26 mildly ill COVID-19 patients, 154 hospitalized patients – including 63 who became critically ill and 23 who eventually died – and 108 uninfected individuals. Saliva viral load, but not nasopharyngeal viral load, was linked with COVID-19 risk factors like age and gender, and with immune system responses. Saliva viral load was also superior to nasopharyngeal viral load at predicting critical illness and death, the researchers reported on Wednesday on medRxiv ahead of peer review. Saliva contains inhaled germs that are cleared from the lungs by the body’s protective mechanisms, coauthor Akiko Iwasaki of Yale University explained in a tweet on Sunday. The saliva viral load therefore reflects how well the virus is making copies of itself all the way through the respiratory tract, from the nose to the lungs, and not just in the nose and back of the throat, Iwasaki said.

(Reporting by Nancy Lapid; Editing by Bill Berkrot)

Pediatric use of COVID-19 antibody drugs not advised by experts; disinfectant use can cause asthma flares

By Nancy Lapid

(Reuters) – The following is a roundup of some of the latest scientific studies on the novel coronavirus and efforts to find treatments and vaccines for COVID-19, the illness caused by the virus.

Experts advise against antibody drugs in pediatric COVID-19

As of now, antibody therapies for COVID-19 should not be used to treat infections with the new coronavirus in children or adolescents, “including those … at high risk of progression to hospitalization or severe disease,” according to a panel of experts from 29 hospitals across North America who reviewed the available evidence. The antibody drugs – bamlanivimab from Eli Lilly and Co and the combination of casirivimab plus imdevimab from Regeneron Pharmaceuticals Inc – were authorized in November by the U.S Food and Drug Administration for emergency use in certain groups of adolescents and adults with mild-to-moderate COVID-19. But in a paper published on Sunday in the Journal of the Pediatric Infectious Diseases Society, the panel of experts said: “The course of COVID-19 in children and adolescents is typically mild and there is no high-quality evidence supporting any high risk groups. There is no evidence for safety and efficacy of monoclonal antibody therapy for treatment of COVID-19 in children or adolescents, limited evidence of modest benefit in adults, and evidence for potential harm.” (https://bit.ly/3b2kVyG)

Disinfecting during pandemic puts asthmatics at risk

Increased cleaning by people with asthma during the pandemic may be triggering flares of their disease, a new report suggests. Researchers who surveyed 795 U.S. adults with asthma between May and September found the proportion who disinfected surfaces with bleach at least five times a week rose by 155% after the pandemic started. Use of disinfectant wipes, sprays, and other liquids also increased, the researchers reported in Journal of Allergy & Clinical Immunology: In Practice. After accounting for other behaviors and risk factors, higher odds of having uncontrolled asthma were linked with greater household use of disinfectant wipes, disinfectant sprays, bleach and water solutions, and other disinfecting liquids. The study does not prove that increased frequency of disinfecting caused uncontrolled asthma. Still, the authors say, people with asthma need safer cleaning options. The U.S. Centers for Disease Control and Prevention advises asthmatics to ask someone else to clean and disinfect surfaces and to stay in another room when cleaners or disinfectants are used and right afterward. It also said soap and water may be sufficient for surfaces and objects that are seldom touched.

News reports paint overly rosy picture of blood treatment

News reports about critically ill COVID-19 patients treated with a last-ditch procedure known as extracorporeal membrane oxygenation, or ECMO, may be painting an unrealistic picture of outcomes, a study suggests. During ECMO, blood is pumped outside of the body through a machine that removes carbon dioxide and adds oxygen before returning the blood back to the body. In a review of media reports about ECMO treatment of COVID-19, doctors found that 92% of patients in the stories survived, whereas average survival rates after ECMO in large studies have ranged from 53% in children to 63% in young and middle-aged adults. Patients receiving the ECMO treatment “remain at substantial risk” of complications and death, but most news reports of COVID-19 patients treated with ECMO did not address these risks, the researchers said on Monday in JAMA Internal Medicine. They say recognition of the exaggerated benefit suggested by media reports may help intensive care unit doctors, patients and families have more realistic discussions about prognosis after ECMO.

(Reporting by Nancy Lapid; Editing by Bill Berkrot)

COVID-19 antibodies last at least three months; so do symptoms for many

By Nancy Lapid

(Reuters) – The following is a roundup of some of the latest scientific studies on the novel coronavirus and efforts to find treatments and vaccines for COVID-19, the illness caused by the virus.

COVID-19 antibodies last at least three months

People infected with COVID-19 develop antibodies targeting the new coronavirus that last for at least three months, according to two reports published on Thursday in Science Immunology. The two studies, together involving nearly 750 patients, both point to immunoglobulin G (IgG) antibodies, which start showing up well after an infection begins, as the longest-lasting. Researchers found IgG antibodies with two targets – a spike protein on the virus that helps it infect cells, and a part of the spike called the receptor binding domain (RBD) – lasted more than 100 days. While the protective effect of COVID-19 antibodies is not completely clear, Jen Gommerman of the University of Toronto, coauthor of the study, said her team also found levels of so-called neutralizing antibodies, which inactivate the virus, “appeared to be very stable.” The other study, from Harvard Medical School, reported similar findings. This means that a properly designed vaccine “should elicit a durable antibody response that has the potential to neutralize the virus,” Gommerman said. Her group also found that antibodies in saliva correlated with antibodies in blood, but at this point the saliva tests are not sensitive enough to replace blood tests.

COVID-19 symptoms linger for months for many

Three months after becoming ill, many COVID-19 patients still have symptoms, two studies confirm, and the more severe the initial infections, the higher the odds of persistent problems. In Spain, doctors checked back with 108 patients, including 44 who had been severely ill. At 12 weeks after diagnosis, 76% still reported after-effects, with 40% reporting three or more coronavirus-related health issues, doctors said in a paper posted on Thursday on medRxiv ahead of peer review. The most common complaints were shortness of breath, physical weakness, cough, chest pain, palpitations, and psychological and cognitive disorders. In a similar study of 233 U.S. COVID-19 patients – eight of whom had been severely ill – one in four still had symptoms 90 days after first feeling ill. Rates were higher for patients who had been sicker: 59.4% at 30 days and 40.6% at 90 days. “But even for very mild and initially asymptomatic cases, 14.3% have complications persist for 30 days or longer,” the authors reported on Sunday on medRxiv. In the U.S. study, the most common persistent symptoms were impaired smell and taste, difficulty concentrating, shortness of breath, memory loss, confusion, headache, heart palpitations, chest pain, pain with deep breaths, dizziness, and rapid heartbeat.

Remdesivir cut COVID-19 recovery time by 5 days

Final data from a large study of Gilead Sciences Inc’s antiviral drug remdesivir showed the treatment cut COVID-19 recovery time by five days among hospitalized patients, one day faster than preliminary data had indicated, researchers reported on Thursday in The New England Journal of Medicine. The 1,062-patient study compared up to up to 10 days of therapy with remdesivir – now sold in some markets as Veklury – to a placebo. The average recovery time was 10 days among those who got the Gilead drug versus 15 days in the placebo group. Among patients requiring oxygen at the start, those taking remdesivir continued to need oxygen for an average of 13 days, compared to 21 days for patients who got a placebo. In a separate analysis looking just at patients who received oxygen, the drug appeared to reduce the risk of death over the next month by 70%. “We now have data suggesting that giving remdesivir to patients on oxygen may significantly reduce their chances of death compared to other subgroups,” Dr. Andre Kalil, an infectious disease expert at the University of Nebraska Medical Center and the study’s lead investigator, said in a news release.

Coronavirus rarely travels from mother to newborn

Transmission of the new coronavirus from mothers to newborns is rare, doctors from New York-Presbyterian/Columbia University Irving Medical Center reported on Monday in JAMA Pediatrics. They studied 101 babies born to 100 mothers with COVID-19, including 10 whose mothers had been severely ill. Almost all of the babies tested negative for the virus, while tests in two newborns had indeterminate results. If these two indeterminate results are considered positive, the overall incidence of transmission was 2.0%. Even with a 2% transmission rate, “none of our babies exhibited clinical symptoms of COVID-19, either during their newborn nursery stay or during … the first few weeks of life,” coauthor Dr. Dani Dumitriu told Reuters Health by email. Roughly 90% of the newborns were breastfed at least partially. “As the country heads into what looks like a second wave of the COVID-19 pandemic, it is important to know that separation of affected mothers from their newborns may not be warranted, and direct breastfeeding appears to be safe,” study coauthor Dr. Melissa Stockwell said.

(Reporting by Nancy Lapid, Julie Steenhuysen and Will Boggs; Editing by Bill Berkrot)

Breathing with face mask does not alter oxygen level; virus can last nine hours on skin

By Nancy Lapid

(Reuters) – The following is a roundup of some of the latest scientific studies on the novel coronavirus and efforts to find treatments and vaccines for COVID-19, the illness caused by the virus.

Breathing with face masks does not affect the lungs

The average face mask may be uncomfortable but does not limit the flow of oxygen to the lungs, even in people with severe lung diseases, researchers say. They tested the effect of wearing surgical masks on gas exchange – the process by which the body adds oxygen to the blood while removing carbon dioxide – in 15 healthy physicians and 15 military veterans with severely impaired lungs via a quick paced six-minute walk on a flat, hard surface. Oxygen and carbon dioxide levels in the blood were measured before and after the walking test. Neither the healthy doctors nor the patients with diseased lungs showed any major changes in gas exchange measurements after the walking test or up to 30 minutes later. Mask discomfort is likely not due to rebreathing of carbon dioxide and decreases in oxygen levels, the researchers reported on Friday in the journal Thorax. Instead, masks may be causing discomfort by irritating sensitive facial nerves, warming inhaled air, or inducing feelings of claustrophobia. Any such discomfort should not cause safety concerns, researchers said, as that could contribute to reduction of “a practice proven to improve public health.”

New coronavirus survives nine hours on human skin

Left undisturbed, the new coronavirus can survive many hours on human skin, a new study has found. To avoid possibly infecting healthy volunteers, researchers conducted lab experiments using cadaver skin that would otherwise have been used for skin grafts. While influenza A virus survived less than two hours on human skin, the novel coronavirus survived for more than nine hours. Both were completely inactivated within 15 seconds by hand sanitizer containing 80% alcohol. The U.S. Centers for Disease Control and Prevention currently recommends using alcohol-based hand rubs with 60% to 95% alcohol or thoroughly washing hands with soap and water for at least 20 seconds. Studies have shown that COVID-19 transmission largely occurs via aerosols and droplets. Still, the authors of the new study conclude in a report published on Saturday in Clinical Infectious Diseases, “Proper hand hygiene is important to prevent the spread of SARS-CoV-2 infections.”

Obstructive sleep apnea linked with worse COVID-19

A common sleep disorder appears to put COVID-19 patients at higher risk for critical illness, a new study finds. Using Finnish national databases, researchers found that while the rates of infection with the new coronavirus were the same for people with and without obstructive sleep apnea (OSA), among people who did become infected, those with OSA had a five-fold higher risk of hospitalization. When people with OSA are asleep, their breathing stops briefly and then restarts, often multiple times during the night. OSA is associated with health problems like obesity, high blood pressure, heart disease, and diabetes, but was linked with a higher risk for severe COVID-19 even after researchers took all these other factors into account. The study cannot prove that OSA caused the more severe outcomes. But in a paper posted on medRxiv ahead of peer review, researchers advise doctors evaluating patients with suspected or confirmed coronavirus infection to recognize that the sleep disorder is a risk factor for severe COVID-19.

Infrared thermometers may be inaccurate in adults

Non-contact infrared thermometers, long used in children and now being used to screen for fever in public places, may not accurately measure body temperature in adults, a small study suggests. The devices are held a short distance from the forehead. Because they never touch the skin, they help prevent transmission of germs and do not need to be sterilized after each use. In a study of 265 adults at two hospitals, Australian researchers compared infrared thermometers with “temporal artery” thermometers, which are rubbed across the forehead. When body temperatures were below 99.5 degrees F (37.5 C), the devices yielded similar results. But for higher body temperatures, the non-contact thermometers “demonstrated poor accuracy,” with greater discrepancies as temperatures rose, according to a report published on Friday in the American Journal of Infection Control. As only 37 study participants had fever, larger studies are needed to confirm these findings, researchers said. Meanwhile, they added, when an infrared thermometer shows a temperature above 99.5 F in an adult, it might be wise to get a direct measurement with a thermometer that makes contact with the body.

(Reporting by Nancy Lapid; Editing by Bill Berkrot)

U.N.’s Guterres calls for $35 billion more for WHO COVID-19 program

ZURICH (Reuters) – United Nations Secretary General Antonio Guterres called for $35 billion more, including $15 billion in the next three months, for the World Health Organization’s (WHO) “ACT Accelerator” program to back vaccines, treatments and diagnostics against COVID-19.

Some $3 billion has been contributed so far, Guterres told an online event on Thursday, calling it “seed funding” that was less than 10% of what the WHO wants for the program, formally called Access to COVID-19 Tools (ACT) Accelerator.

Financial support has, so far, lagged goals, as nations or governments including the European Union, Britain, Japan and the United States reach bilateral deals for vaccines, prompting Guterres and WHO General Director Tedros Adhanom Ghebreyesus to plead to nations to contribute.

“We now need $35 billion more to go from ‘start up’ to ‘scale up and impact’,” Guterres said in online remarks at a meeting of a council formed to help the ACT Accelerator gain traction. “There is real urgency in these numbers. Without an infusion of $15 billion over the next three months, beginning immediately, we will lose the window of opportunity.”

European Commission President Ursula von der Leyen pledged backing, having in August already promised 400 million euros ($474 million) to the COVAX vaccine portion of the program.

“It is difficult to find a more compelling investment case. The European Commission will remain deeply and entirely committed to the success of the ACT Accelerator,” von der Leyen said. “The world needs it, we all need it.”

Tedros renewed calls for scaling up COVID-19 clinical trials. AstraZeneca this week suspended late-stage trials on its potential vaccine after an illness in a participant in Britain. Chief Executive Pascal Soriot said on Thursday if safety reviewers allow a restart, the company should still know by year’s end if its vaccine works.

(Reporting by John Miller; Editing by Michael Shields)

Severe COVID-19 riskier than heart attack for young adults; antibiotic shows no benefit

By Nancy Lapid

(Reuters) – The following is a roundup of some of the latest scientific studies on the novel coronavirus and efforts to find treatments and vaccines for COVID-19, the illness caused by the virus.

More young adults survive heart attacks than severe COVID-19

Among COVID-19 patients treated at 419 U.S. hospitals from April through June, only about 5% were ages 18 to 34. But that group had “substantial rates of adverse outcomes,” according to a report on Wednesday in JAMA Internal Medicine. Roughly one in five needed intensive care, one in 10 needed mechanical ventilation, and nearly 3% died. While the mortality rate is lower than in older adults, it is roughly double the death rate of young adults from heart attacks, the authors say. Obesity, high blood pressure, and diabetes were tied to higher risk for adverse events. For young adults with more than one of these conditions, the risk of a bad outcome was similar to middle-aged adults without the risk factors. More than half of hospitalized young adults were Black or Hispanic, “consistent with prior findings of disproportionate illness severity in these demographic groups,” the authors said. “Given the sharply rising rates of COVID-19 infection in young adults, these findings underscore the importance of infection prevention measures in this age group,” the concluded.

Antibiotic fails to help hospitalized COVID-19 patients

The antibiotic azithromycin did not appear to provide any benefit to hospitalized COVID-19 patients who were having trouble breathing, according to a study in Brazil. At 57 hospitals, 243 COVID-19 patients who needed oxygen or mechanical ventilation were randomly assigned to receive azithromycin, while 183 similar patients did not get the antibiotic. All received other standard treatment, which in Brazil included hydroxychloroquine, a malaria drug that other studies have shown provides little or no benefit. While azithromycin did not appear to do any harm, after 15 days it was not associated with any patient improvement nor did it reduce their risk of death. In an April survey of more than 6,000 physicians in 30 countries, azithromycin was the second most commonly prescribed treatment for COVID-19, the study investigators wrote in The Lancet medical journal. The absence of any benefit in this new study “suggests that the routine use of this strategy should be avoided,” they said.

Risk of catching COVID-19 while hospitalized can be low

Among nearly 8,500 patients admitted to a large Boston hospital between early March and the end of May, only two became sick with coronavirus infections that may have been acquired while they were hospitalized, doctors report. One likely was infected by a spouse who initially appeared well during daily visits but who developed symptoms while the patient was still hospitalized. That was before visitor restrictions and universal masking rules had been implemented. The other patient developed symptoms four days after leaving the hospital. The source of the infection is not known. According to a paper published on Wednesday in JAMA Network Open, infection control efforts at the hospital included dedicated COVID-19 units with airborne infection isolation rooms, personal protective equipment for staff and monitoring to make sure those were used correctly, universal masking, visitor restriction, and liberal COVID-19 testing of symptomatic and asymptomatic patients. These “robust and rigorous infection control practices may be associated with minimized risk” of COVID-19 spreading through hospitals, the authors conclude. Their findings, if replicated at other U.S. hospitals, “should provide reassurance to patients,” they said.

Longer-term COVID-19 lung damage can improve over time

COVID-19 lung damage persists long term but tends to improve, researchers reported on Monday at the European Respiratory Society International Virtual Congress. Researchers studied 86 hospitalized COVID-19 patients, 48% of whom had a smoking history and 21% of whom required intensive care. At 6 weeks after discharge, 47% of patients still reported feeling short of breath. By 12 weeks, that dropped to 39%. CT scans still showed lung damage in 88% of patients at six weeks, dropping to 56% at 12 weeks. “Overall, this study shows that COVID-19 survivors have persisting pulmonary impairment weeks after recovery. Yet, overtime, a moderate improvement is detectable,” lead researcher Dr. Sabina Sahanic, from University Clinic of Internal Medicine in Innsbruck, Austria, said during a press briefing. A related study featured at the meeting stressed the importance of early pulmonary rehabilitation after COVID-19 patients come off a ventilator. This should include balance and walking, muscle strengthening, respiratory exercises and endurance training. “The sooner rehabilitation started and the longer it lasted, the faster and better was the improvement in patients’ walking and breathing capacities and muscle gain,” coauthor Yara Al Chikhanie, from Grenoble Alps University in France, said in a statement.

(Reporting by Nancy Lapid; Editing by Bill Berkrot)

COVID-19 often goes undiagnosed in hospital workers; virus may impair heart functions

By Nancy Lapid

(Reuters) – The following is a roundup of some of the latest scientific studies on the novel coronavirus and efforts to find treatments and vaccines for COVID-19, the illness caused by the virus.

COVID-19 often undiagnosed in front line hospital workers

A high proportion of COVID-19 infections among U.S. healthcare personnel appear to go undetected, according to a report on Monday in the Morbidity and Mortality Weekly Report of the U.S. Centers for Disease Control and Prevention. Between April and June, among more than 3,000 front line workers in 12 states, roughly 1 in 20 had antibody evidence of a previous COVID-19 infection, but 69% of those infections had never been diagnosed. Among those with antibodies to the novel coronavirus, about one-third did not recall having symptoms in the preceding months, nearly half did not suspect that they had been infected, and some two-thirds had never had a positive COVID-19 test. Infections among front line healthcare personnel may be going undetected, the study authors say, because some infections may be only minimally symptomatic or asymptomatic and also because personnel with symptoms may not always have access to testing. COVID-19 antibodies were less common among workers who reported using a face covering for all patient encounters and more common among those who reported a shortage of personal protective equipment. The researchers call for more frequent testing of healthcare personnel and universal use of face coverings in hospitals.

Virus may impair heart’s beating, contracting

Following recent reports that the new coronavirus can invade heart muscle cells comes the discovery that infected cells show impairments in function. In test tube experiments, researchers infected “myocytes,” or heart muscle cells, with the new coronavirus and found that before the infected cells die, they progressively lose their “electrophysiological and contractile properties.” This means they have trouble transmitting the electrical impulses that regulate heartbeats and shortening or lengthening their fibers so the heart can expand and contract to pump blood. In a paper posted online Sunday on bioRxiv ahead of peer review, the researchers note that their test tube experiments likely do not exactly replicate what happens with cells in the body, and more research is needed to confirm their findings. Still, they say, their results suggest that cardiac symptoms in COVID-19 patients are likely a direct effect of the virus and warn that “long-term cardiac complications might be possible … in patients who recover from this illness.”

Eye symptoms common in children with COVID-19

Children with COVID-19 often have non-serious eye symptoms like itching, discharge, or pink eye, a study from China suggests. Among 216 children hospitalized with COVID-19 in Wuhan, the epicenter of the outbreak there, 23% had these kinds of eye issues, doctors found. Eye problems were more common in children with other symptoms such as cough or fever. In all cases, the eye problems were mild and eventually went away either without treatment or with “minimal” eye drops, researchers reported in JAMA Ophthalmology. It is reassuring that most of the children had other symptoms first, said Dr. Douglas Fredrick, chief of pediatric ophthalmology at the Mount Sinai Health system in New York City, who was not involved in the study. If conjunctivitis, or pink eye, were always among the first symptoms, “we’d be more worried that children could spread this by pink eye from one child to another,” he told Reuters. Still, he said, the study doesn’t completely rule out that type of transmission.

Cell phone activity may predict COVID-19 spread

Cell phone use patterns suggest that when people stay home, coronavirus infection rates go down, researchers say. For a study published on Monday in JAMA Internal Medicine, they analyzed publicly available de-identified cell phone activity and location data collected between January and May from 2,740 counties across the United States. After mid-February, when the coronavirus outbreak began, cell phone activity declined significantly in workplaces, stores and restaurants, and mass transit stations and increased in homes – with the greatest initial changes seen in areas with higher rates of COVID-19. Two weeks after cell phone activity shifted away from workplaces and retail locations, the counties with the most pronounced changes had the lowest rates of new COVID-19 cases. “Perhaps reassuringly,” the researchers said, cell phone activity at grocery stores and in areas classified as parks was not strongly associated with rates of growth in COVID-19 cases. They speculate that publicly available cell phone location data might help health offices better predict COVID-19 growth rates and inform decision about where to implement shutdowns and re-openings.

(Reporting by Nancy Lapid and Linda Carroll; Editing by Bill Berkrot)

COVID-19 reinfection detected in U.S. patient; saliva tests endorsed

By Nancy Lapid

(Reuters) – The following is a roundup of some of the latest scientific studies on the novel coronavirus and efforts to find treatments and vaccines for COVID-19, the illness caused by the virus.

COVID-19 reinfection seen in U.S. patient

A case of coronavirus reinfection has been documented in a U.S. patient from Reno, Nevada, according to doctors. The 25-year-old man tested positive for the virus in April after showing mild illness and then got sick again in late May, developing more severe COVID-19 symptoms. Doctors and Nevada public health officials said they were able to show through sophisticated testing that the virus associated with each instance of infection represented genetically different strains. Their report, released on Friday, is undergoing peer review by the Lancet medical journal. Last week, three reinfections were reported – one in Hong Kong and two in Europe. Unlike the Nevada case, the second infections in those patients were milder than the first. Reinfection “may represent a rare event,” the Nevada researchers wrote. But, they said, the findings implied that initial exposure to the virus may not result in full immunity for everyone who has been infected by it.

Saliva samples preferable for COVID-19 testing

Letting patients provide saliva samples for COVID-19 tests is easier and safer than swabbing the back of the nose and throat for samples to test, and the results are equally reliable, Yale University researchers said. Writing on Friday in the New England Journal of Medicine, they compared saliva and nasopharyngeal swab samples from 70 U.S. hospitalized COVID-19 patients and 495 asymptomatic healthcare workers, using gold-standard laboratory methods. In both groups, the saliva tests and the nasopharyngeal swab tests showed similar sensitivity for detecting the virus. For healthcare workers, unlike the collection of nasopharyngeal samples, collection of saliva samples by patients does not present a risk of infection and alleviates demands for supplies of swabs and personal protective equipment, the researchers said. In a separate study on Friday in the journal Annals of Internal Medicine, Canadian researchers employed an experimental saliva test kit and found that it might miss some mild or asymptomatic infections. But they agreed with the Yale researchers about the advantages of saliva tests and said they “may be of particular benefit for remote, vulnerable or challenging” patients.

Accuracy of faster COVID-19 tests is unclear

It is hard to know whether so-called point-of-care COVID-19 tests, which provide results in a couple of hours rather than days as some other tests do, are accurate, according to a research review. The authors of the review, published on Wednesday by the Cochrane Library, focused on two types of rapid point-of-care tests: antigen tests, which identify proteins on the virus using disposable devices, and molecular tests, which detect viral genetic material using portable or table-top devices. Altogether, they reviewed 22 studies from around the world that compared point-of-care tests to gold-standard so-called RT-PCR laboratory tests. Three-quarters of the studies did not follow the point-of-care test manufacturers’ instructions, they found. There also was little information about study participants, so it was not possible to tell if the results could be applied to people with no symptoms, mild symptoms or severe symptoms. And studies often were at risk for bias, or did not detail their methods. “The evidence currently is not strong enough and more studies are urgently needed to be able to say if these tests are good enough to be used in practice,” the research team led by Jonathan Deeks of the University of Birmingham in Britain wrote.

New studies add to data on COVID-19 in children

Children are far less likely than adults to get severe cases of COVID-19, British doctors found. At 138 hospitals in Britain, through June, less than 1% of COVID-19 patients were children, and 99% survived. Those who died had serious underlying health conditions. “We can be quite sure that COVID in itself is not causing harm to children on a significant scale,” said Malcolm Semple of the University of Liverpool, co-author of research published on Thursday in BMJ. While children’s risk for severe COVID-19 is low, Black children and obese children experienced higher risks. A separate study published on Monday in the journal JAMA Pediatrics suggests the proportion of U.S. children with asymptomatic COVID-19 may be low. At 28 hospitals, more than 33,000 children were tested during ear, nose and throat appointments or procedures. None were suspected of having the virus. Fewer than 1% were asymptomatically infected. Even without symptoms, infected children can shed virus for weeks, Korean doctors said on Friday in the JAMA Pediatrics.

(Reporting by Nancy Lapid, Kate Kelland and Deena Beasley; Editing by Will Dunham)

T cells play a role in fighting coronavirus; COVID-19 affects children differently

By Nancy Lapid

NEW YORK (Reuters) – The following is a brief roundup of some of the latest scientific studies on the novel coronavirus and efforts to find treatments and vaccines for COVID-19, the illness caused by the virus.

Immune system’s T cells play a role in attacking the coronavirus

While the immune system’s B cells make antibodies that block the novel coronavirus, its T cells provide another line of attack, according to new research. Researchers found that T cells from recovered patients can target the virus. That is promising news for vaccine developers because it is “consistent with normal, good, antiviral immunity,” Shane Crotty, from the Center for Infectious Disease and Vaccine Research at the La Jolla Institute for Immunology in California, told Reuters. “The types of immune responses targeted by many candidate vaccines are now shown to be the types of immune responses seen in COVID-19 cases that successfully recovered from the disease.” Furthermore, some people who never had COVID-19 nonetheless had T cells that could attack the virus, Crotty’s team reported on Thursday in the journal Cell. This suggests that past exposure to other coronaviruses (such as those that cause the common cold) had somehow primed their T cells to recognize and attack this new coronavirus. That might influence their susceptibility to COVID-19 disease, he said, either preventing them from getting infected or from developing severe disease.

Coronavirus affects adults and children differently

Children appear to have much lower rates of infection with the new coronavirus than adults, but most reports on COVID-19 in youngsters have focused only on small groups. A team of Chinese researchers has analyzed data from 24 earlier studies involving a total of nearly 2,600 children with COVID-19, enabling them to shed light on ways in which the virus acts differently in pediatric patients. They reported on Sunday in the Journal of Medical Virology that the most common laboratory test abnormality observed in adults was a low level of immune cells called lymphocytes (B cells and T cells). This condition, known as lymphopenia, developed in up to 80% of adults but in less than 10% of children. On the other hand, children – particularly infants – were more likely to have elevated levels of cardiac enzymes that indicate heart injury. They also found additional differences. The rates of severe illness and critical illness in adults were 14% and 5%, respectively (according to earlier reports). That compared with 4.4% and 0.9% in children. Fever occurred in up to 99% of adults but in 43% of children; cough in up to 82% of adults but 43% of children. Shortness of breath and acute respiratory distress syndrome (ARDS) were rare in children, but digestive tract symptoms like diarrhea were more common in kids than in grownups.

Coronavirus can infect patients taking hydroxychloroquine

Taking hydroxychloroquine for other medical conditions might not protect against the new coronavirus, French doctors say. The drug had nearly become a standard of care for patients with COVID-19 in many hospitals, even though randomized trials have not yet confirmed its value. But people around the world use decades-old hydroxychloroquine to treat malaria as well as inflammatory conditions like lupus and rheumatoid arthritis, and researchers are seeing occasional cases of coronavirus infection in these patients despite long-term use of the drug. A report on Sunday in the Journal of Antimicrobial Chemotherapy describes two such patients, one with rheumatoid arthritis and the other with a condition called mixed connectivitis. The authors say they also know of at least three other patients in Italy who became sick with COVID-19 despite taking hydroxychloroquine for chronic arthritis. “Patients actually taking long-term hydroxychloroquine are potentially immunosuppressed patients since they are living with chronic inflammatory diseases and thus do not represent the general population exposed to COVID-19,” the French doctors acknowledge. “However, these observational data are not in favor of a universal protective effect of hydroxychloroquine.”

New barcoding technique can help process 100,000 screening tests per day

A big challenge in preventing the spread of the new coronavirus is to identify and quarantine infected people who do not have symptoms. Laboratory workers can test blood samples from thousands of patients per day, still not enough to efficiently screen heavily populated areas. Now researchers at the OSU James Comprehensive Cancer Center in Columbus, Ohio say they have a way to screen over 100,000 samples per day. Their system, dubbed REMBRANDT, makes copies of the virus and introduces two barcodes that simplify patient identification. Barcoding of samples for screening is not new, but the OSU method takes a unique biochemical approach, aiming for a single barcoding and virus-copying step. “Barcodes on products in the supermarket and molecular barcodes for REMBRANDT work the same way,” investigator Richard Fishel told Reuters. “In this case, each patient has a unique combination of letters that allows for their simplified identification. With ten Next Generation sequencing machines, REMBRANDT can test every Ohio resident for COVID-19 infection every 10 days – an important step in contact tracing and reducing the spread of infection.” His team’s report, published on Sunday on the preprint server bioRxiv, has not yet been peer reviewed. “Our next step,” Fishel said, “will be to collaborate with hospitals and public health departments to clinically validate REMBRANDT and make it available to a wider audience.”

(Reporting by Nancy Lapid; Editing by Bill Berkrot)