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🦘Cacatman's Personal Coronavirus COVID-19 Update Thread

Ophthalmic Signs of COVID-19
Investigators from Singapore National Eye Centre in Singapore reported that the retina may show signs of COVID-19 infection even before they appear in the rest of the body.

The researchers theorized that “the retinal microvascular signs may result from cardiovascular and thrombotic alterations associated with COVID-19 infection.”
 
Cardiac Sequelae

Athletes & COVID-19

Most (82%) of the athletes had COVID-19 symptoms; the symptoms were mild for the majority (68%); and none required treatment or hospitalization. The most frequent symptoms were the loss of smell/taste (58%), fever (less than 2 days, 42%), headache (41%) and fatigue (40%). Less frequently reported symptoms were shortness of breath (12%) and chest pain/tightness (11%). African American and Hispanic athletes were more often symptomatic compared to white athletes (86% and 100% vs. 75%, respectively). No differences in symptoms or severity were found based on gender or sport.

Researchers found:
  • Less than 4% (5) of the 137 athletes showed heart abnormalities on initial screening tests.
  • Further screening via cardiac MRI of the 5 athletes identified found no heart damage or inflammation.
  • After COVID-19 recovery, all athletes were able to resume their full training and competition regimens without any complications.

No adverse cardiac events related to SARS-CoV-2 infections observed among more than 3,000 collegiate athletes during short-term clinical surveillance.

Nearly 900 of the study’s participants underwent a COVID-19 test after reporting COVID-like symptoms, and 27% tested positive. The mean age of patients testing positive for COVID-19 was 45.3 years old, and 70.9% were women. The mean age of patients with a negative test was 44.7 years old, and 71.1% were women.

Looking closely at RHR data, Radin et al. found that patients with a confirmed COVID-19 diagnosis experienced “a transient bradycardia followed by a prolonged relative tachycardia that did not return to baseline, on average, until 79 days after symptom onset.”
 
Breakthrough/Deaths in Vaccinated People

  • Half of states (25) report some data on COVID-19 breakthrough events (see Table 1). Twenty-four provide data on breakthrough cases, 19 on hospitalizations and on deaths.
  • Fifteen of these states regularly update these data, often on a weekly basis. The rest use a different frequency, have one-time reports, have stopped updating, or have an unclear reporting frequency.
  • The data reported from these states indicate that breakthrough cases, hospitalizations, and deaths are extremely rare events among those who are fully vaccinated against COVID-19 (see Figure 1). The rate of breakthrough cases reported among those fully vaccinated is well below 1% in all reporting states, ranging from 0.01% in Connecticut to 0.29% in Alaska.
    • The hospitalization rate among fully vaccinated people with COVID-19 ranged from effectively zero (0.00%) in California, Delaware, D.C., Indiana, New Jersey, New Mexico, Vermont, and Virginia to 0.06% in Arkansas. (Note: Hospitalization may or may not have been due to COVID-19.)
    • The rates of death among fully vaccinated people with COVID-19 were even lower, effectively zero (0.00%) in all but two reporting states, Arkansas and Michigan where they were 0.01%. (Note: Deaths may or may not have been due to COVID-19.)

    • COVID-19 Vaccine Breakthrough Cases: Data from the States
 
Transmission in Children higher in 0-3 yo age group
Among these dwellings, 1,717 (27.3 per cent) appeared to experience secondary transmissions, meaning at least one other person in the home became infected with the novel coronavirus within two weeks of the initial case.

The original infected children were divided into four age groups (0–3, 4–8, 9–13 and 14–17 years old). Of these groups, children aged 0 to 3 years had the highest odds of transmission. Children aged 4 to 8 years and 9 to 13 years also had higher odds of transmission than the eldest group. The results indicate younger children may be more likely to transmit COVID-19 compared to older children.

 
Advice for Vaccination of Immunocompromised people

The FDA on Aug. 12 amended the emergency use authorizations for both the Pfizer-BioNTech and Moderna COVID-19 vaccines to allow for the use of an additional dose in certain immunocompromised individuals, specifically solid organ transplant recipients or patients considered to have an equivalent level of immunocompromise. The CDC's Advisory Committee on Immunization Practices agreed at its Aug. 13 meeting, recommending a third shot for moderately to severely immunocompromised patients ages 12 years and over, according to a CNN report. A letter published by the New England Journal of Medicine(NEJM) on Aug. 11 reported that a third dose increased antibody levels in transplant patients. The randomized, placebo-controlled trial included 120 patients with solid organ transplants and found no hospitalizations or organ rejections resulting from the extra vaccination. “Overall, at this juncture, the benefit of third-dose vaccination, at least with the mRNA-1273 vaccine, appears to outweigh the risks,” said an accompanying editorial. Another letter in NEJM, published Aug. 12, reported similar results from third doses given to about 100 transplant recipients. Two research letters published by JAMA Oncology on Aug. 11 focused on the limited effectiveness of two-shot vaccination in immunocompromised patients, specifically those in active cancer treatment and with hematologic malignant disease.
 
Vaccines and Thrombosis/CVT

The high mortality associated with VITT was highest among patients with a low platelet count and intracranial hemorrhage. Treatment remains uncertain, but identification of prognostic markers may help guide effective management. (Funded by the Oxford University Hospitals NHS Foundation Trust.)
 
Treatment - Beta blocker, metoprolol improved oxygenation and ICU ventilation in patients when given IV

In previous work, the researchers showed that metoprolol, but not other clinically available intravenous beta-blockers, abrogates neutrophil-driven exacerbated inflammation, neutrophil-platelet interaction, and formation of neutrophil extracellular traps (NETs) in a mouse model of acute lung injury.
 
any news/info about people getting covid-19 twice or perhaps even 3 times?
Good morning Tom,
Forgive me if you already know the below information. I know you run the other COVID thread.
re: your question
What the studies I've seen (as well as the real world observations) seem to show that it is possible for people to get reinfected with COVID-19. There are some slightly different scenarios though.

Last year when COVID-19 was emerging (and there were no vaccines), there were literally only a handful of documented cases (less than 50 cases worldwide) of people being reinfected with the virus. This did include some deaths in that group (if they had other concomitant illnesses e.g. immunocompromised etc).

But this year, there are more documented cases of reinfection. The reason, I believe, is because of variants. The virus has become sufficiently different, so as to reduce the effectiveness of both vaccines (to the original COVID-19), as well as those who have been unvaccinated. This is why in fully vaccinated people, there are cases of "breakthrough" infections.

But there is a big difference between the above two groups. "Breakthrough" infections are not very serious in those who are 2 weeks post their second vaccination ie. there is way less admission to hospital/ICU/endpoint of death in this cohort and they limit spread to others because they don't get the high concentrations of virus in their system and aren't sick for as long as "first-timers".

To use an analogy, having a vaccination is like using a safety belt in a car. Just like vaccinations, safety belts occasionally kill people e.g. if they get jammed and people get stuck in a burning/sinking car. However, overall, safety belts will save more people if used. People dying from a safety belt is not a reason NOT to use it. And of course, the "benefits" of using a safety belt will be more advantageous if you are driving on a freeway (c.f. exposed to more people in a city). Taking the analogy further, safety belts that were made in the 1960s will still save your life in a lot of accidents, but using a current safety belt that has pretensioners and made of better material, will better protect you and give you a better chance of survival.

Stay safe, bro!
 
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