Category: COVID19

‘Long COVID’ symptoms include ongoing fatigue, joint pains and breathlessness many months after the acute phase of the disease is over.

The novel coronavirus may cause an imbalance in gut bacteria which is partly responsible for ‘long COVID’, new research finds.

Long COVID symptoms include ongoing fatigue, joint pains and breathlessness many months after the acute phase of the disease is over.

Patients who have had COVID also have poor gut microbiome composition and changes in bacterial diversity.

The gut may have a part in lasting inflammatory symptoms after the infection has gone.

Past studies have suggested that the gut and its microorganisms can alter the immune system response.

For the present study, researchers collected the blood and stool samples of 100 hospitalised COVID patients and 78 non-COVID adults.

COVID severity in patients was identified as:

• mild if the X-ray showed no evidence of pneumonia,
• moderate if pneumonia with fever and respiratory tract symptoms were detected,
• severe if patients had serious breathing problems,
• and critical if they needed mechanical ventilation or had organ failure ending to intensive care.

The results showed a large difference in the composition of the gut microbiota between patients with and without COVID.

The number of Ruminococcus torques, Bacteroides dorei, and Ruminococcus gnavus spices was higher in COVID patients than those with no infection.

In contrast, COVID patients had lower amounts of Faecalibacterium prausnitzii, Eubacterium rectale, and Bifidobacterium adolescentis, which are beneficial bacteria for the immune system.

The illness was more severe in patients with lower level of Bifidobacterium bifidum and F. prausnitzii (an anti-inflammatory bacterium).

The immune cells secrete inflammatory cytokines in reaction to the virus but sometimes they overreact causing cytokine storms.

Hypercytokinemia or cytokine storm syndrome is a life-threatening condition that can lead to septic shock, damage to the body’s tissues, and lung failure.

Also, the microbial imbalance in patients with COVID was linked to high levels of inflammatory cytokines and C-reactive protein, an inflammation marker.

The authors wrote:

“In light of reports that a subset of recovered patients with COVID-19 experience persistent symptoms, such as fatigue, dyspnoea [breathlessness] and joint pains, some over 80 days after initial onset of symptoms, we posit that the dysbiotic gut microbiome could contribute to immune-related health problems post-COVID-19.”

According to another study, leaky gut syndrome is another condition that enables the COVID virus to get through the surface of internal organs and the digestive tract, making the infection worse.

The authors added:

“Bolstering of beneficial gut species depleted in COVID-19 could serve as a novel avenue to mitigate severe disease, underscoring the importance of managing patients’ gut microbiota during and after COVID-19.”

One study has suggested the use of a probiotic formula to address gut dysbiosis in order to enhance immune defence against viral infections such as COVID.

The study was published in the journal GUT (Yeoh et al., 2021).

An antiviral drug promising to be highly effective against SARS-CoV-2, the virus that causes COVID-19.

An antiviral extracted from a plant known as ‘the deadly carrot’ could help in the fight against COVID, new research finds.

The antiviral, called Thapsigargin, is extracted from the Thapsia garganica plant.

The extract might significantly shift the way the coronavirus pandemic is manged.

Thapsigargin has a broad-spectrum antiviral effect, with the ability to block different types of viruses and be effective against a wide range of micro-organisms.

A new study reveals that thapsigargin treatment is extremely effective against the influenza A virus, respiratory syncytial virus (RSV), common cold coronaviruses, and COVID-19

A variety of viruses can cause acute respiratory virus infections, but they are clinically identical.

The possibility of making a powerful broad-spectrum antiviral drug widely available would curb infection and prevent its spread.

When the research team looking for options they noticed that taking small amounts of thapsigargin generates a very effective innate immune antiviral responses against SARS-CoV-2 and other respiratory viruses.

The reasons that makes this plant-derived product a favourable antiviral are as follow:

• It isn’t broken down by stomach acid so it can be administered orally instead of by injection.
• If taken during early infection, it disrupts the virus which gives antibodies and cell-mediated immunity a chance to get ready.
• If exposed to a virus for 30 minutes, then the virus can’t reproduce itself for at least 48 hours.
• Several hundred times more powerful than other antiviral products.
• Viruses usually mutate to become resistant to a treatment, but this doesn’t work for thapsigargin.
• It blocks combined infection with flu and SARS-CoV-2 as effectively as infection with one virus.
• Thapsigargin is safe as it has been used for treating prostate cancer.

Professor Kin-Chow Chang, the study’s senior author, said:

“Whilst we are still at the early stages of research into this antiviral and its impact on how viruses such as COVID-19 can be treated, these findings are hugely significant.

The current pandemic highlights the need for effective antivirals to treat active infections, as well as vaccines, to prevent the infection.

Given that future pandemics are likely to be of animal origin, where animal to human (zoonotic) and reverse zoonotic (human to animal) spread take place, a new generation of antivirals, such as thapsigargin, could play a key role in the control and treatment of important viral infections in both humans and animals.

Although more testing is clearly needed, current findings strongly indicate that thapsigargin and its derivatives are promising antiviral treatments against COVID-19 and influenza virus, and have the potential to defend us against the next Disease X pandemic.”

The study was published in the journal Viruses (Al-Beltagi et al., 2021).

The reason men’s lives are in greater danger than women from the coronavirus.

It is hard to understand why being a man is such a strong risk factor for dying from COVID-19.

Now, though, Yale researchers have revealed biological mechanisms that make men more vulnerable than women to SARS-CoV-2.

Their research has revealed that the immune response is affected by aging depending on sex, which in turn influences the incidence and severity of COVID-19.

The differences in genetic makeup and sex hormones may account for the doubling of the COVID mortality risk in men.

The female sex hormone estrogen reduces the ability of the virus to infect cells and the two X chromosomes keep the immune system alert to detect pathogens.

This basic biology provides a higher protection for women.

Professor Akiko Iwasaki, the study’s first author, said:

“Age and sex are where immunological changes intersect.”

Recent studies show that gene expression regulates our immune response and tells the immune cells how to react to a threat.

Immunity weakens with age, but due to lower gene expression related to adaptive immunity the decline is much faster in men.

The changes in immune system in men occur dramatically between ages 62 and 64 whereas the decline in immune responses starts in women six years later than that.

Iwasaki’s lab has identified certain molecules that improve immune response against COVID-19 and those causing adverse effects on health.

The research explains why the risk of death for the virus is 1.7 times higher in men than women.

It seems that X chromosomes contain genes that control the immune responses.

Women have two X chromosomes which is an advantage here.

In women, when one X chromosome is silenced the other chromosome is still active meaning the immune system will get more effective against an infection than in men with their single X chromosome.

Also, the male sex hormone androgen appears to be an important factor associated with worse outcomes, while the female sex hormone estrogen provides protection in woman with COVID-19.

Estrogen suppresses ACE 2 receptors which are the entry point for SARS-CoV-2 to infect cells.

On the other hand, androgen increases the virus’ ability to infect cells.

Age is another risk factor disrupting immune responses in men against the coronavirus.

Males in their early 60s lack the ability to create an initial immune response against the virus so other immune system molecules overreact to compensate for this issue.

This may lead to cytokine storm, a life-threatening inflammatory syndrome which can lead to lung failure in some COVID-19 patients.

Professor Iwasaki concluded:

“I knew we would learn a lot about immunity to this virus by studying sex differences, but I didn’t know the findings would be this clear.

Hopefully, vaccines will start to level the playing field between men and women and reduce deaths for everyone.”

The study was published in the journal Science (Takahashi & Iwasaki, 2021).

Whether a patient’s immune system can fight off COVID-19 infection might depend on one thing from the past.

The effectiveness of people’s immune system against SARS-CoV-2 may depend on antibodies produced from previous coronavirus infections responsible for common colds, a study has found.

This is not the first time that humans have battled a coronavirus; before COVID-19, mankind has faced six types of coronaviruses, at least.

The name coronavirus is given to these viruses because their surface is full of crown-like (corona) spike proteins.

The research team wanted to know how coronaviruses flare up our immune system and how human adaptive immunity works after being exposed to the virus for the first time.

Dr John Altin, the study’s senior author, said:

“Our results suggest that the COVID-19 virus may awaken an antibody response that existed in humans prior to our current pandemic, meaning that we might already have some degree of pre-existing immunity to this virus.”

This understanding can help scientists to develop efficient vaccines or monoclonal antibody treatments to protect humans from novel coronavirus mutations.

The research team used PepSeq, a tool to map antibody responses against any coronavirus infecting humans.

Dr Jason Ladner, the study’s first author, said:

“The data generated using PepSeq allowed for broad characterization of the antibody response in individuals recently infected with SARS-CoV-2 compared with those of individuals exposed only to previous coronaviruses that now are widespread in human populations.”

As well as SARS-CoV-2, the team studied the antibody responses to life threatening SARS-CoV-1, the first pandemic coronavirus responsible for the 2003 outbreak and Middle East Respiratory Syndrome (MERS) responsible for the 2012 outbreak.

All three viruses were initially found in animals but evolved to infect humans and make them sick.

The team also tested the antibody responses to four older coronaviruses causing mild infection: betacoronavirus OC43, betacoronavirus HKU1, alphacoronavirus 229E, and alphacoronavirus NL63, which are responsible for common colds.

They found that SARS-CoV-2 summons those antibodies produced in response to pervious coronavirus infections.

Dr Altin said:

“Our findings highlight sites at which the SARS-CoV-2 response appears to be shaped by previous coronavirus exposures, and which have potential to raise broadly-neutralizing antibodies.

We further demonstrate that these cross-reactive antibodies preferentially bind to endemic coronavirus peptides, suggesting that the response to SARS-CoV-2 at these regions may be constrained by previous coronavirus exposure.”

This might explain why COVID-19 patients react differently to the virus as some show no symptoms, some have mild symptoms, and some have severe infections causing hospitalization or death.

Dr Ladner said:

“Our findings raise the possibility that the nature of an individual’s antibody response to prior endemic coronavirus infection may impact the course of COVID-19 disease.”

The study was published in the journal Cell Reports Medicine (Ladner et al., 2020).

The possible side-effects of Moderna’s COVID-19 vaccine in some people.

Moderna’s vaccine is effective in preventing severe COVID-19 and has been highly praised since the clinical trials have shown a 94.1 percent protection rate.

However, the public needs to be aware of the possible adverse effects, even if there are no serious safety concerns.

The Moderna vaccine phase 3 clinical trial results show that, in general, reactions to the vaccine like pain, redness, and swelling at the site of injection were mild.

Nevertheless, 50 percent of recipients after the second dose experienced moderate-to-severe side-effects such as headache, muscle aches, joint pain, and fatigue.

The side-effects were temporary, occurring 15 hours after the injection and disappearing in most cases by day 2 with no consequences.

Expected adverse reactions after vaccination

Dr Luke Hutchison a computational biologist, who participated in Moderna’s coronavirus vaccine trial talks about his experience in an article published in the journal Science.

He said his arm swelled up to the size of a goose egg after the second dose and within a few hours he had a 38.9°C fever and muscle aches:

“I started shaking.

I had cold and hot rushes.

I was sitting by the phone all night long thinking: ‘Should I call 911?’”

The symptoms were resolved after 12 hours, but as he points out nobody had prepared him for the severity of the reaction.

He added that people should be told about the possible adverse reactions as some people, soon after vaccination, might experience these symptoms.

According to Professor Florian Krammer, a vaccinologist who participated in Pfizer’s trial, those short-term side effects (reactogenicity) should not stop people from getting vaccinated because the coronavirus kills 1 in every 200 people that it infects.

He said:

“Sore arms, fevers, and fatigue are “unpleasant but not dangerous.”

Data analysis of Moderna’s vaccine trial by an independent board suggests several severe side-effects as follows:

• fatigue in 9.7 percent,
• muscle pain in 8.9 percent,
• joint pain in 5.2 percent,
• headache in 4.5 percent,
• and fevers of 39°C to 40°C in 2 percent of participants.

Most people will have no or mild side-effects after receiving a Pfizer or Moderna vaccine, but if only 2 percent of 500 million people across the world who get either the Pfizer or Moderna vaccine develop severe fevers, that would be 10 million people.

Professor Arnold Monto, an epidemiologist at the University of Michigan School of Public Health, said:

“This is higher reactogenicity than is ordinarily seen with most flu vaccines, even the high-dose ones.”

Side-effects are sign of normal response

Many experts believe that the side-effects are normal signs, showing an effective immune response to the vaccine.

Professor Drew Weissman, an immunologist at the University of Pennsylvania whose work was important for the COVID-19 vaccines, said:

“Both Moderna’s and Pfizer/BioNTech’s vaccines require two doses separated by several weeks.

Reactogenicity is typically higher after a second dose.

The side effects “mean the vaccine is working well. …

[It] means you had such a good immune response to the first dose and now you are seeing the effects of that.

We suspect the lipid nanoparticle causes the reactogenicity, because lipid nanoparticles without mRNA in them do the same thing in animals.

We see production, in the muscle, of inflammatory mediators that cause pain, [redness], swelling, fever, flulike symptoms, etc.”

→ Read on: The Common Side-Effects Of The Pfizer Vaccine

The study was published in The New England Journal of Medicine (Baden et al., 2021); The article published in Science (Wadman, 2020).

Artificial intelligence can foresee if you will die from COVID-19, even before infection.

A computer model used by researchers in Denmark can predict whether a person will die before they even get infected with the coronavirus.

Being older and overweight are the main predictors, along with being a man and having high blood pressure.

The model determines the progression of the disease and death showing who should be the first to receive the SARS-CoV-2 vaccine in Denmark.

The model’s prediction of whether a person with no evidence of COVID-19 infection would die or survive was 90 percent accurate.

The model’s prediction of whether a person will be admitted to hospital and Intensive Care Unit (ICU) or require a respirator was 80 percent accurate.

Professor Mads Nielsen, study co-author, said:

“We began working on the models to assist hospitals, as during the first wave, they feared that they did not have enough respirators for intensive care patients.

Our new findings could also be used to carefully identify who needs a vaccine.”

Since the COVID-19 outbreak, scientists have been working on machine learning (ML) models to predict the severity of the disease before people become ill by using their health records.

The computer program was designed to look for patterns in people’s history of illness and how they fought against COVID-19.

Professor Nielsen said:

“Our results demonstrate, unsurprisingly, that age and BMI are the most decisive parameters for how severely a person will be affected by COVID-19.

But the likelihood of dying or ending up on a respirator is also heightened if you are male, have high blood pressure or a neurological disease.”

According to the study, health risk factors and chronic diseases are the keys to find out whether a COVID-19 patient will need a breathing machine or respirator.

BMI, age, high blood pressure, being male, neurological diseases, Chronic obstructive pulmonary disease (COPD), asthma, diabetes and heart disease were the key parameters in predicting the risk of hospital and ICU admission, use of mechanical ventilation, and death.

Professor Nielsen said:

“For those affected by one or more of these parameters, we have found that it may make sense to move them up in the vaccine queue, to avoid any risk of them becoming inflected and eventually ending up on a respirator.”

The research team are hoping to develop a program to help hospitals foresee whether they need respirators several days in advance.

Professor Nielsen said:

“We are working towards a goal that we should be able to predict the need for respirators five days ahead by giving the computer access to health data on all COVID positives in the region.

The computer will never be able to replace a doctor’s assessment, but it can help doctors and hospitals see many COVID-19 infected patients at once and set ongoing priorities.”

The study was published in the journal Scientific Reports (Jimenez-Solem et al., 2021).

These active ingredients found in mouthwash can inactivate over 99.9% of the coronavirus.

Some over‐the‐counter mouthwashes, gargles, and nasal rinses can make human coronaviruses inactive, a study found.

These products seem to lower the amount of virus (viral load) in an infected person’s mouth and so reduce the transmission of SARS-CoV-2, which is responsible for COVID-19.

Oral and nasal cavities are the major entry points and spreaders of human coronaviruses.

Professor Craig Meyers and his team tested several nasal rinses and mouthwash gargling products for their level of protection against human coronaviruses.

The mouthwashes included were Peroxide Sore Mouth Cleanser, Hydrogen peroxide diluted to 1.5 percent in PBS solution, Listerine and Orajel Antiseptic Rinse.

The nasal rinses were Neti Pot solution (made based on manufacturer’s instructions), Johnson’s Baby Shampoo diluted to 1 percent in PBS solution.

Some of these products were able to neutralize the human coronavirus, suggesting their potential ability to reduce virus spread by COVID-19 patients.

Professor Meyers said:

“While we wait for a vaccine, methods to reduce transmission are needed.

The products we tested are readily available and often already part of people’s daily routines.”

They tested those products on a human coronavirus genetically similar to SARS-CoV-2 in a laboratory, the contact time with the virus was 30 seconds, one minute, and two minutes.

The 1 percent baby shampoo solution during the two-minute contact time was able to inactivate more than 99.9 percent of the virus whereas the over‐the‐counter saline nasal rinse and Neti Pot had no effect on the virus.

Also several over‐the‐counter antiseptic mouth washes with alcohol‐based eucalyptol, menthol, methyl salicylate, and thymol formulations were able to inactivate 99.9 percent of infectious virus.

Another study has suggested that chemicals such as ethanol, cetylpyridinium, and povidone-iodine commonly found in dental mouthwashes can destroy the outer shell of fat of many enveloped viruses.

These experimental findings show that certain types of oral rinses such as Listerine antiseptic have the inactivating properties which can be highly effective on reducing the viral load of SARS-CoV-2 even outside the lab.

Professor Meyers said:

“People who test positive for COVID-19 and return home to quarantine may possibly transmit the virus to those they live with.

Certain professions including dentists and other health care workers are at a constant risk of exposure.

Clinical trials are needed to determine if these products can reduce the amount of virus COVID-positive patients or those with high-risk occupations may spread while talking, coughing or sneezing.

Even if the use of these solutions could reduce transmission by 50%, it would have a major impact.”

The study was published in the Journal of Medical Virology  (Meyers et al., 2020).

A cocktail of drugs can prevent 100 percent of symptomatic COVID-19 infections by “passive immunization”.

A combination of drugs can prevent 100 percent of COVID-19 infections, researchers at the University of Virginia Health System have found.

The antibody cocktail is called REGN-COV and is aimed at people who live or come into contact with a COVID-19 patient.

Although it provides a short-term benefit, the drug can block symptomatic infections for those who share a household with a COVID-19 patient.

Moreover, those with no symptoms (asymptomatic) have a lower amount of the virus in their body (viral load) and so the infections resolve in seven days.

Dr William Petri, the leader of this clinical trial, said:

“This is the first treatment shown to prevent COVID-19 after a known exposure, and offers protection for unvaccinated individuals caring for a family member with COVID-19.

We expect that Regeneron will file for emergency use authorization from the FDA so that this drug can be used outside of the context of a clinical trial.”

This is “passive immunization” using antibodies to prevent people from developing disease, despite being exposed to the virus.

For this study, 400 people participated, with 186 receiving the antibody cocktail treatment and the rest getting a placebo.

The results showed that the coronavirus infection rates, both asymptomatic and symptomatic, were 50 percent less in the antibody group compared to the placebo group.

The viral load in placebo recipients who developed infections was 100 times bigger than infected people from the antibody group.

Those in the antibody group who got COVID-19 recovered from the disease within a week, whereas the recovery period was three to four weeks for those patients in the placebo group.

The antibody cocktail is able to reduce the duration of viral shedding, the time when the virus replicates in the body.

Since the viral particles that are being shed can be infectious then reducing the period will lower the risk of spreading the disease.

Dr Petri said:

“Antibody treatments like this are in a way a stop-gap and so, until we can have everyone vaccinated, antibody treatment is in a way beneficial to people that are at risk of the most severe complications of the infection.”

It is likely that the antibody cocktail will also be effective against new coronavirus variants.

Dr Petri said:

“These combinations of antibodies are probably going to be more effective at treating and preventing infections from the new variants because it’s much harder for the virus to mutate around two different antibodies than a single one.”

The antibody cocktail is different with a vaccine and it cannot give long-term protection from COVID-19.

→ The study has not been published in a scientific journal yet.

How effective is the Pfizer vaccine and do people need a second shot for immunity?

A single shot of the Pfizer-BioNTech COVID-19 vaccine gives people 90 percent protection 3 weeks after injection.

A study reveals that people in Israel who received the first jab of the Pfizer vaccine were highly protected against the SARS-CoV-2 virus.

However, it can take up to 21 days after the initial injection for a single dose to achieve 90 percent immunity from the disease.

If the protection is that high then having a second dose seems to be unnecessary and wasteful when most countries are struggling to secure a vaccine.

The recommended time frame for a second dose is after 21 days but in the UK the current decision has been to delay this up to 12 weeks after the first injection.

The present study supports the UK’s plan but the authors highlight that the risk of infection is doubled during the first eight days after injection due to people became careless after having their vaccine.

Professor f Paul Hunter, the study’s first author, said:

“A second dose of the Pfizer vaccine would normally be given 21 days or more after the first to top up and lengthen the effect of the first dose.

But here in the UK, the decision was made to delay the timing of the second injection until 12 weeks after the first.

The logic behind this is to protect more people sooner and so reduce the total number of severe infections, hospitalisations, and deaths.

But this decision caused criticism from some quarters due in part to a belief that a single injection may not give adequate immunity.

A recent non peer-reviewed pre-print paper based on Israel’s experience looked at data from 500,000 people who had been given the Pfizer vaccine.

It reported that a single dose may not provide adequate protection.

But we saw a number of flaws in how they looked at the data including the fact that they did not attempt to estimate the effectiveness of the vaccine from day 18 onwards.

This would have given a better indication of how effective a single dose of the vaccine could be if the second dose was delayed by up to 12 weeks.”

The team wanted to find out how effective a single dose of the Pfizer COVID-19 vaccine is by using real-world data.

The outcome suggests that the number of coronavirus cases will increase for eight days after the first dose but then will decline to their lowest by day 21.

Professor Hunter said:

“Surprisingly, the daily incidence of cases increased strongly after vaccination till about day eight—approximately doubling.

We don’t know why there was this initial surge in infection risk but it may be related to people being less cautious about maintaining protective behaviours as soon as they have the injection.

We found that the vaccine effectiveness was still pretty much zero until about 14 days after people were vaccinated.

But then after day 14 immunity rose gradually day by day to about 90 percent at day 21 and then didn’t improve any further.

All the observed improvement was before any second injection.

This shows that a single dose of vaccine is highly protective, although it can take up to 21 days to achieve this.

And it supports the UK policy of extending the gap between doses by showing that a single dose can give a high level of protection.

Whilst we do not know how long this immunity will last beyond 21 days without a second booster, we are unlikely to see any major decline during the following nine weeks.

The study was published in medRxiv (Hunter & Brainard, 2021).