Study: COVID-19 Damages Lungs Differently From the Flu

New research reveals that COVID-19 attacks the lungs in a far different manner from the flu.

Unlike most respiratory diseases, significant impacts on blood vessels were seen in the lungs of seven COVID-19 patients. The lung tissue of those patients was compared to lung tissue from seven people who died of pneumonia caused by the flu.

There was evidence that COVID-19 attacks the lining of lung blood vessels and COVID-19 patients’ lungs had many tiny blood clots and grew new blood vessels in response, according to the study published May 21 in the New England Journal of Medicine.

The findings support reports from doctors treating COVID-19 patients of widespread damage to lung blood vessels and the presence of blood clots that aren’t typical in a respiratory disease, the Washington Post reported.

“What’s different about COVID-19 is the lungs don’t get stiff or injured or destroyed before there’s hypoxia [oxygen deprivation],” study co-author Dr. Steven Mentzer, a professor of surgery at Harvard Medical School, told the newspaper.

“For whatever reason, there is a vascular phase” along with the damage more often linked with viral diseases such as the flu, he said.

The finding that the “lungs from patients with COVID-19 had significant new vessel growth” was “unexpected,” the researchers added.

This may have been an attempt by the lungs to get more oxygen to oxygen-starved tissue, Mentzer told the Post.

“That may be one of the things that gets people better,” he said.

Mentzer and his colleagues also tried to identify genetic or other factors that might help identify people who are most susceptible to severe COVID-19 illness, but weren’t able to pinpoint any.

Certain groups of people have been hardest hit by COVID-19, including older patients, those with underlying diseases such as diabetes, and black Americans, the Post reported.

Other researchers have found similar damage and unexpected blood clots in other organs, such as the kidneys and heart, of COVID-19 patients, according to the newspaper.

Source: HealthDay

Too Little Sleep Can Mean More Asthma Attacks in Adults

A good night’s sleep is crucial to good health. A new article in Annals of Allergy, Asthma and Immunology, the scientific journal of the American College of Allergy, Asthma and Immunology (ACAAI) reveals that too little sleep, and occasionally too much sleep, can negatively impact adults with asthma.

“Previous research revealed that poor sleep quality has a negative effect on asthma symptoms in adolescents,” says Faith Luyster, PhD, lead author of the study. “Our study shows that adults with asthma are equally affected by too little (or sometimes too much) sleep. Compared to normal sleepers, short and long sleepers had a higher proportion of people who reported having an asthma attack in the past year (45 percent vs. 59 percent and 51 percent respectively) and had more days with impaired health-related quality of life. Impaired quality of life was characterized by more days of poor physical and mental health.

The study surveyed 1,389 adults who were 20 years and older who self-identified as having asthma. Of the group, 25.9 percent slept 5 hours or less, 65.9 percent slept 6-8 hours and 8.2 percent slept 9 or more hours. Sleep duration was measured by a single question, “How much sleep do you usually get at night on weekdays or workdays?” “Short sleepers” were more likely to be younger and non-White, while “long sleepers” were more likely to be older, female and a smoker.

Short sleepers, as compared to normal sleepers, had a greater likelihood of an asthma attack, dry cough, and an overnight hospitalization during the past year. Short sleepers also had significantly worse health related quality of life — including days of poor physical and mental health and inactive days due to poor health — and more frequent general healthcare use during the past year as compared to normal sleepers. The odds for long sleepers to have some activity limitation due to wheezing was higher when compared to normal sleepers. No significant differences in other patient-reported outcomes and healthcare use were observed between the long and normal sleepers.

“Disturbed sleep in an asthma patient can be a red flag indicating their asthma isn’t well-controlled,” says allergist Gailen D. Marshall, MD, PhD, ACAAI member and Editor-in-Chief of Annals. “This study adds solid evidence to the practice of asthma patients discussing sleep issues with their allergist to help determine if they need to change their asthma plan to achieve adequate sleep as a component of overall good asthma management. It also warns that consequences can be expected when sleep patterns are chronically inadequate.”

Source: American College of Allergy, Asthma & Immunology

Today’s Comic

Breastfeeding May Help Guard Against Diabetes

Breastfeeding is good for more than babies: New research suggests it may protect new mothers from developing diabetes for years after they give birth.

The study included 85 women who breastfed and 99 who did not. They were assessed two months after giving birth and each year after that for at least three years.

Compared to those who didn’t breastfeed, mothers who breastfed had improved pancreatic beta cell mass and function and lower blood glucose (sugar) levels, reducing their risk of diabetes, the investigators found.

These benefits continued after women stopped breastfeeding, lasting for more than three years after they gave birth, according to the study published recently in the journal Science Translational Medicine.

The South Korean researchers said the milk-secreting hormone “prolactin” in breastfeeding mothers not only promotes milk production, but also stimulates insulin-secreting pancreatic beta cells that regulate blood glucose.

The researchers also found that “serotonin” — a chemical that contributes to well-being and happiness — is produced in pancreatic beta cells during breastfeeding. Serotonin in pancreatic beta cells act as an antioxidant and reduce oxidative stress, making mothers’ beta cells healthier.

Serotonin also induces the proliferation of beta cells, thereby increasing the beta cell mass and helping maintain proper glucose levels, according to the researchers at the Korea Advanced Institute of Science and Technology.

Because pregnancy causes weight gain and increased insulin resistance, it can increase the risk of diabetes. Other factors — such as a history of gestational diabetes, age and obesity — also affect a pregnant woman’s risk of developing diabetes after giving birth.

The risk of diabetes after delivery is highest among women who’ve had gestational diabetes and/or repeated deliveries, the study authors noted.

“We are happy to prove that lactation benefits female metabolic health by improving beta cell mass and function as well as glycemic control,” said Hail Kim, a professor in the institute’s Graduate School of Medical Science and Engineering.

“Our future studies … may lead to new therapeutics to help prevent mothers from developing metabolic disorders,” Kim added in an institute news release.

Source: HealthDay

Today’s Comic

Different Trigger Points for Seeking Healthcare May Explain Gender Divide

Men might not be more reluctant to see a doctor than women are, as is popularly believed, but may simply have different trigger points for seeking healthcare, suggests research published online in the Journal of Epidemiology & Community Health.

The threshold for making an appointment with a family doctor seems to be lower among women, while older women also tend to live longer with disabling conditions than men do, so more of them will be accessing primary care, the findings indicate.

Women tend to live longer than men after a serious illness, with their greater use of primary healthcare, and therefore greater likelihood of timely diagnosis, often suggested as the explanation for this particular advantage.

To explore this further, the researchers looked at the patterns of primary healthcare use among 65, 622 Danish men and women aged 60 and above, before and after admission to hospital for serious illness between 1999 and 2011.

Serious illness included: stroke; heart attack; chronic obstructive pulmonary disease (COPD); and cancers of the digestive tract, which are among the leading causes of admission to hospital in Denmark.

Every primary care consultation was recorded for each person in five 6-month periods in the 30 months before and the 30 months after first admission to hospital for one of the four conditions.

The average age at which women were admitted to hospital was significantly older than that of men: 77 vs 75.

Once engaged with primary healthcare, patterns of use didn’t differ significantly between men and women.

But before hospital admission, while a substantial proportion of women didn’t access primary healthcare, men were still significantly less likely than women to do so for all four conditions.

And after hospital admission, with the exception of stroke, the gap had narrowed considerably as both sexes were more likely to access primary healthcare.

For example, before hospital admission, one in four (25%) of all men in their 60s admitted with a heart attack hadn’t used primary healthcare services compared with around one in seven (15%) of all women of the same age.

But afterwards, only 2% of all men and only 1% of all women who had been admitted for a heart attack didn’t visit their family doctor.

Absolute gender differences in primary healthcare use were greatest for stroke and heart attack, the symptoms of which often come on suddenly or if already present, might be overlooked, say the researchers.

At the other end of the spectrum, the gender gap in primary healthcare use was generally smallest for COPD, the symptoms of which tend to be present long before admission.

This suggests that men and women may be just as likely to put off seeing a doctor when they don’t consider symptoms to require urgent attention or when they ignore them, say the researchers.

Similarly, fear of the implications of a diagnosis of a serious illness may also deter both sexes from seeking medical help.

This is an observational study, and as such, can’t establish cause, added to which the researchers weren’t able to assess whether a visit to a doctor was directly related to the reason for hospital admission, or whether it concerned prevention or ongoing treatment.

And the findings may not be more widely applicable to healthcare systems beyond Denmark, where primary healthcare services are free for all citizens, they point out.

Nevertheless, they suggest: “The stronger post-hospitalisation changes among men may indicate that men might have been more reluctant to engage with primary healthcare before experiencing a health shock.”

And they conclude: “Our findings indicate a lower threshold for treatment-seeking among women. In addition, higher levels of primary healthcare use among women may be underpinned by the fact that women are more likely to survive with disabling conditions following hospitalisation.”

Both men and women should be encouraged to see their family doctor to ensure that health issues get picked up early before they become more serious, they suggest.

Source: BMJ

LA County Coronavirus Infections Are Up to 55 Times That of Reported Cases

An early analysis of antibody testing from Los Angeles County finds a coronavirus infection rate that is up to 55 times the number of confirmed COVID-19 cases.

According to the researchers behind the study, the vast majority of people infected with the new coronavirus may be going without symptoms or have minimal symptoms.

It’s one of the first in-depth analyses of local population infection rates conducted in the United States.

Los Angeles County’s population totals more than 10 million. As the research team noted, by early April, there were 7,994 confirmed cases of COVID-19 reported in the county, including 600 COVID-19 deaths.

But new findings from the first round of ongoing antibody blood testing of county residents showed that about 4.1% of adults had antibodies to the coronavirus.

Adjusting for any statistical margin of error, that suggests that between 2.8% to 5.6% of the county’s adults have antibodies to the coronavirus, which translates to between 221,000 to 442,000 adults in Los Angeles County having already had the infection.

That estimate is 28 to 55 times higher than the number of confirmed cases of COVID-19 reported to the county by the time of the study in early April, said researchers from the University of Southern California (USC) and the Los Angeles County Department of Public Health.

“We haven’t known the true extent of COVID-19 infections in our community because we have only tested people with symptoms, and the availability of tests has been limited,” lead investigator Neeraj Sood, professor of public policy and senior fellow at the Center for Health Policy and Economics at USC, explained in a university news release.

Now that the true, and much wider, penetration of coronavirus within the general public is known, “we might have to recalibrate disease prediction models and rethink public health strategies,” Sood said.

Dr. Barbara Ferrer directs the L.A. County Department of Public Health. Speaking in the news release, she said the antibody test results “indicate that many persons may have been unknowingly infected and at risk of transmitting the virus to others.”

The study also highlights the need for expanded polymerase chain reaction (PCR) testing, she said, so infected individuals “can be isolated and quarantined, while also maintaining the broad social distancing interventions.” The antibody test can help detect past coronavirus infection, but a PCR test is required to diagnose current infection, Ferrer explained.

According to study co-leader Dr. Paul Simon, chief science officer at L.A. County Department of Public Health, “Though the results indicate a lower risk of death among those with infection than was previously thought, the number of COVID-related deaths each day continues to mount, highlighting the need for continued vigorous prevention and control efforts.”

The researchers plan to test new groups of people every few weeks over the coming months to assess the pandemic’s spread in the county.

Source: HealthDay