Category: Corona Virus

Severe COVID-19 causes early lung capillary thrombosis, leading to respiratory distress, with studies emphasizing prompt anti-coagulation treatment to mitigate complications.

Blood clot formation (thrombosis) in the small blood vessels of the lungs is an early result of severe COVID-19, often occurring before the breathing difficulties caused by widespread damage to the air sacs, according to a Brazilian study reported in an article published in the Journal of Applied Physiology. Post-mortem examinations of nine individuals who passed away from severe COVID-19 revealed a distinct pattern of changes in lung blood vessel structure and thrombosis.

For the first time, the article describes sub-cellular aspects of the endothelial damage and associated thrombotic phenomena caused by the infection. It notes the impact of acute inflammation on lung microvascular circulation as the key factor in severe COVID-19, contributing to a deeper understanding of the pathophysiology of the disease and the development of novel therapeutic strategies.

This study furnished the final proof of what wed been pointing out since the very start of the pandemic that severe COVID-19 is a thrombotic disease. The virus SARS-CoV-2 has a tropism for [is attracted to] the endothelium, the layer of cells that lines blood vessels. When it invades endothelial cells, it first affects microvascular circulation. The problem starts in the capillaries of the lungs [the tiny blood vessels that surround the alveoli], followed by clotting in the larger vessels that can reach any other organ, said pulmonologist Elnara Negri, first author of the article and a professor at the University of So Paulos Medical School (FM-USP). She was one of the first researchers in the world to reach the conclusion that severe COVID-19 is a thrombotic disease.

The researchers at USP analyzed lung tissue from nine patients who died from COVID-19. Credit: Elia Caldini

In the study, which was supported by FAPESP, the researchers used transmission and scanning electron microscopy to observe the effects of the virus on lung endothelial cells from severe COVID-19 patients who died at Hospital das Clnicas, the hospital complex operated by FM-USP.

All nine samples obtained by minimally invasive autopsies displayed a high prevalence of thrombotic microangiopathy microscopic blood clots in small arteries and capillaries that can lead to organ damage and ischemic tissue injury. The samples came from patients who were hospitalized between March and May 2020, required intubation and intensive care, and died owing to refractory hypoxemia and acute respiratory failure.

It is worth noting that none of the patients included in the study was treated with anti-coagulants, as this was not part of the COVID-19 treatment protocol at the time. Nor were any COVID-19 vaccines available in the period.

Negri explained that the endothelium is itself lined by a gel-like layer of glycoproteins called the glycocalyx, which acts as a barrier to regulate the access of macromolecules and blood cells to the endothelial surface. This barrier prevents clotting in blood vessels by inhibiting platelet interaction with the endothelium.

Previous studies conducted by Helena Nader at UNIFESP [the Federal University of So Paulo] showed that SARS-CoV-2 invades cells mainly by binding to the receptor ACE-2 [a protein on the surface of various cell types, including epithelial and endothelial cells in the respiratory system] but before that, it binds to heparan sulfate [a polysaccharide], a major component of the glycocalyx in endothelial cells. When it invades the endothelium, it triggers shedding and destruction of the glycocalyx, resulting in tissue exposure and intravascular clotting. The process starts in the microcirculation, Negri explained.

Because the virus initially acts on the pulmonary microcirculation, contrast examinations performed during the pandemic to investigate the presence of blood clots in larger vessels in severe COVID-19 patients failed to detect the problem at any early stage, she added. However, endothelial dysfunction is a key phenomenon in COVID-19 since it is directly associated with the activation of the inflammatory response that is characteristic of the disease.

Massive viral invasion and destruction of the endothelium break down the endothelial barrier and impair the recruitment of circulating immune cells, activating pathways associated with thrombogenesis and inflammation, she said.

In the study, the researchers found that endothelial injury tended to precede two common processes in cases of respiratory distress: significant alveolar-capillary membrane leakage, and intra-alveolar accumulation of fibrin (associated with blood clotting and wound healing).

A study by the same group at FM-USP, led by Thais Mauad and including transcriptomics (analysis of all RNA transcripts, coding, and non-coding), showed that several pathways associated with blood clotting and platelet activation had been activated prior to inflammation in the lungs of patients with alveolar damage.

The analysis also confirmed that the clotting was not typical of the usual process triggered by the activation of coagulation factors. In COVID-19, the clotting is due to endothelial injury and exacerbated by NETosis [an immune mechanism involving programmed cell death via formation of neutrophil extracellular traps or NETs], dysmorphic red blood cells and platelet activation, all of which makes the blood thicker and causes many complications, Negri said.

When the blood is thick and highly thrombogenic, she added, the patient must be kept hydrated, whereas diffuse alveolar damage in acute respiratory distress syndromes due to other causes requires reduced hydration. Also, the timing and rigorous control of anti-coagulation are fundamental, she stressed.

Another study by the same group of researchers, including Marisa Dolhnikoff and Elia Caldini, showed lung damage in severe COVID-19 to be associated with the degree of NETosis: the higher the level of NETs in lung tissue obtained by autopsy, the more the lungs were damaged.

Negri said she began to suspect there was a link between COVID-19 and thrombosis early in the pandemic when she noticed a phenomenon recalling her experience some 30 years ago with patients who had microvascular clotting after open-heart surgery with extracorporeal circulation and a bubble oxygenator, no longer used because it causes endothelial damage.

It was a widely used technique 30 years ago, but it causes lung injury very similar to that seen in COVID-19. So Id already seen it. Besides the pulmonary injury, another similarity is the occurrence of peripheral thrombotic phenomena, such as red toes, for example, she said.

As severe COVID-19 sets in, the drop in blood oxygen levels is secondary to pulmonary capillary thrombosis. Initially, theres no buildup of fluid in the lungs, which arent saturated and dont lose their compliance or elasticity. This means the lungs in early severe COVID-19 patients dont look like sponges full of liquid, as they do in acute respiratory distress syndrome [ARDS] patients. On the contrary, the respiratory failure associated with severe COVID-19 involves dehydration of the lungs. The alveoli fill with air but the oxygen cant enter the bloodstream because of capillary clotting. This leads to what we call happy hypoxia, where patients dont experience shortness of breath and arent aware their oxygen saturation is dangerously low.

While observing the intubation of a severe COVID-19 patient, Negri realized the treatment of such cases should be entirely different from what it was at the start of the pandemic. The secret to treating severe COVID-19 patients is keeping them hydrated and using anti-coagulant at the right dose, meaning the dose required in the hospital environment at the onset of oxygen desaturation, i.e. low levels of oxygen in the blood, she said. After that, the therapeutic dose of anti-coagulant must be calculated daily on the basis of blood work, always in the hospital environment to avoid any risk of bleeding. Prophylaxis is required for an average of four to six weeks after discharge because thats how long the endothelium takes to regenerate.

This hydration and anti-coagulation protocol is needed because, in contrast with other kinds of ARDS in which oxygen in the lungs is prevented from entering the bloodstream mainly by alveolar inflammation, lung capillary endothelial damage is the main obstacle in early severe COVID-19, she explained.

No one knew about this difference between COVID-19 and other types of ARDS at the very start of the pandemic. Indeed, this is why so many Italian patients died in ICUs [intensive care units], for example. The treatment protocol used then was different, she recalled.

In 2020, before the study was reported in the Journal of Applied Physiology, Negri and her group had already observed that the use of the anti-coagulant heparin improved oxygen saturation in critical patients. In 2021, in collaboration with colleagues in several countries, they conducted a randomized clinical trial in which they succeeded in demonstrating that treatment with heparin reduced severe COVID-19 mortality. The findings were published in the British Medical Journal.

That study helped bring about a global change in COVID-19 treatment guidelines by showing that COVID-19 mortality risk fell 78% when anti-coagulation was started in patients who needed oxygen supplementation but werent yet in intensive care, Negri said.

Endothelial dysfunction should be reversed without delay in severe COVID-19, using an anti-coagulant, she explained. Blood clotting has to be stopped as soon as possible in order to avert the development of acute respiratory distress and other consequences of the disease, such as the problems now known as long COVID, she said.

An article recently published in Nature Medicine by researchers affiliated with institutions in the United Kingdom reinforces the thrombotic nature of the disease, reporting a study in which the only long COVID prognostic markers identified were fibrinogen and D-dimer, proteins associated with coagulation.

The study shows that long COVID results from inadequately treated thrombosis. The microcirculatory problem can persist in several organs, including the brain, heart, and muscles, as if the patient were having small heart attacks, Negri said.

Reference: Ultrastructural characterization of alveolar microvascular damage in severe COVID-19 respiratory failure by Elnara Marcia Negri, Marlene Benchimol, Thais Mauad, Amaro Nunes Duarte-Neto, Maiara Gottardi, Luiz Fernando Ferraz da Silva, Paulo Hilario Nascimento Saldiva, Marisa Dolhnikoff, Wanderley de Souza and Elia Garcia Caldini, 1 October 2023, Journal of Applied Physiology. DOI: 10.1152/japplphysiol.00424.2023

Acute blood biomarker profiles predict cognitive deficits 6 and 12 months after COVID-19 hospitalization by Maxime Taquet, Zuzanna Skorniewska, Adam Hampshire, James D. Chalmers, Ling-Pei Ho, Alex Horsley, Michael Marks, Krisnah Poinasamy, Betty Raman, Olivia C. Leavy, Matthew Richardson, Omer Elneima, Hamish J. C. McAuley, Aarti Shikotra, Amisha Singapuri, Marco Sereno, Ruth M. Saunders, Victoria C. Harris, Linzy Houchen-Wolloff, Neil J. Greening, Parisa Mansoori, Ewen M. Harrison, Annemarie B. Docherty, Nazir I. Lone, Jennifer Quint, Naveed Sattar, Christopher E. Brightling, Louise V. Wain, Rachael E. Evans, John R. Geddes, Paul J. Harrison and PHOSP-COVID Study Collaborative Group, 31 August 2023, Nature Medicine. DOI: 10.1038/s41591-023-02525-y

The study was funded by the So Paulo Research Foundation.

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Scientists Have Proven That Severe COVID-19 Is a Thrombotic Disease - SciTechDaily

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Scientists at La Jolla Institute for Immunology (LJI) have found direct evidence that exposure to common cold coronaviruses can train T cells to fight SARS-CoV-2. In fact, prior exposure to a common cold coronavirus appears to partially protect mice from lung damage during a subsequent SARS-CoV-2 infection.

The new research, published recently in Nature Communications, provides an important first look at how "cross-reactive" T cellswhich can fight multiple viruses from the same familydevelop in an animal model. "We are learning how these immune cells develop and function," says study co-leader LJI Research Instructor Annie Elong Ngono, Ph.D.

The Shresta Laboratory is now working to develop novel vaccines purposefully designed to harness these powerful T cells. Those vaccines would protect against SARS-CoV-2 and provide immunity against several other coronaviruses with pandemic potential.

"Our research will help scientists design and improve 'pan-coronavirus' vaccines that elicit broad, cross-protective responses," adds LJI Professor Sujan Shresta, Ph.D., study senior leader and member of LJI's Center for Vaccine Innovation.

T cells tend to be specialists. They learn to hunt down specific molecular targets, called epitopes, that belong to specific pathogens. "Cross-reactive" T cells are important for human health because they recognize epitope targets on differentbut closely relatedpathogens, such as different members of the coronavirus family. This viral family includes common cold coronaviruses and serious pathogens such as SARS-CoV-2.

The COVID-19 pandemic put cross-reactive T cells in the spotlight. In early 2020, LJI Professors Shane Crotty, Ph.D., and Alessandro Sette, Dr.Biol.Sci., discovered that many peoplewho had never been exposed to SARS-CoV-2already had T cells that recognized the novel coronavirus. How did these T cells know what to look for?

SARS-CoV-2 only emerged in 2019, but many people had contracted common cold coronaviruses long before then. LJI scientists showed that cross-reactive T cells could recognize targets on both viruses. In follow-up studies, researchers even found an association between cross-reactive T cells and a lower risk of developing severe COVID-19.

If T cells could learn to target both viruses at once, perhaps scientists could design a vaccine against many types of coronaviruses, including new SARS-CoV-2 variants. That was the hopebut there was still a lot to learn.

"To design better vaccines we need to know exactly how these protective T cells develop and how long that window of protection lasts," says LJI Postdoctoral Fellow Rbens Alves, Ph.D., who served as first author of the new study.

The Shresta Lab is working to answer those questions. The lab members specialize in developing humanized mouse models, which allows them to study infectious diseases and human-relevant immune cell responses in a controlled environment.

For the new study, the researchers used mouse strains that can produce the exact same variety of T cells as the ones found in humans. The researchers infected these mice with one of the most widespread common cold coronaviruses, called OC43. SARS-CoV-2 and OC43 are both betacoronaviruses.

The scientists found that mice infected with OC43 produced CD4+ "helper" T cells and CD8+ "killer" T cells that cross-reacted with SARS-CoV-2. Those cells targeted the same epitopes as T cells collected from humans with SARS-CoV-2 exposure.

Next, the researchers developed a model of sequential infectionwith OC43 infection followed by SARS-CoV-2 in these humanized mice. They examined whether the cross-reactive T cells actually helped protect the mice from severe COVID-19.

Cross-reactive CD4+ "helper" T cells did indeed help counteract the virus's assault on the respiratory system. Mice with previous OC43 exposure showed lower levels of SARS-CoV-2 infection in their airways and were less likely to develop pneumonia and lung damage. Cross-reactive T cells really did help prevent severe disease.

"Our lab's expertise in mouse models has allowed us to go deeper into what human studies have suggested," says Elong Ngono.

SARS-CoV-2 is not the first coronavirus to cause a deadly outbreak. SARS, which caused a deadly outbreak in 2003, was also a coronavirus. So is MERS. This new study is an important step in understanding how T cells might learn to recognize and cross-react to many coronaviruses at onceincluding emerging SARS-CoV-2 variants and other family members with pandemic potential.

Going forward, the team would like to investigate how exposure to other kinds of common cold coronaviruses affects T cells. Will cross-reactive T cells still develop? Would they seek the same shared epitopes or different targets?

"We now have the mouse model to study different human infection scenarios, such as the common situation when a person has been infected many times by different common cold coronaviruses before encountering SARS-CoV-2," says Shresta. "We even have a model now to characterize different SARS-CoV-2 vaccine-elicited human relevant T cell responses and determine the contribution of these T cells to the vaccine-induced protection."

Shresta says the Institute is well equipped to move forward with this pandemic prevention research. She credits the LJI for making sure LJI scientists have the vital training and facilities for infectious disease research. Shresta also emphasizes that philanthropic support made it possible for the Institute to construct a biosafety level 3 laboratory for thisand many othercritical studies.

Additional authors of the study, "Common cold coronavirus-elicited CD4+ T cells protect against SARS-CoV-2 in HLA transgenic mice," include Julia Timis, Robyn Miller, Kristen Valentine, Paolla Beatriz Almeida Pinto, Andrew Gonzalez, Jose Angel Regla-Nava, Erin Maule, Michael N Nguyen, Norazizah Shafee, Sara Landeras Bueno, Eduardo Olmedillas, Brett Laffey, Katarzyna Dobaczewska, Zbigniew Mikulski, Sara McArdle, Sarah R. Leist, Kenneth Kim, Ralph S. Baric, and Erica Ollmann Saphire.

More information: Rbens Prince dos Santos Alves et al, Human coronavirus OC43-elicited CD4+ T cells protect against SARS-CoV-2 in HLA transgenic mice, Nature Communications (2024). DOI: 10.1038/s41467-024-45043-2

Journal information: Nature Communications

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Common cold or COVID-19? Some T cells are ready to combat both - Medical Xpress

The Centers for Disease Control and Prevention estimates that up to 86% of new COVID-19 cases stem from the latest mutation, JN.1. The most recent COVID vaccines are expected to help lower chances of serious illness or hospitalization from JN.1. Rogelio V. Solis/AP hide caption

The Centers for Disease Control and Prevention estimates that up to 86% of new COVID-19 cases stem from the latest mutation, JN.1. The most recent COVID vaccines are expected to help lower chances of serious illness or hospitalization from JN.1.

A new, fast-spreading variant of COVID-19 is sweeping across the nation, making it the most widely circulating iteration of the virus in the U.S. and around the world, according to the Centers for Disease Control and Prevention.

The mutation, called JN.1, is a subvariant of Omicron that was first detected by the World Health Organization in late August. At the time it appeared to be spreading slowly but as temperatures have dipped, JN.1 has spiked.

In mid-October, CDC data shows JN.1 made up about 0.1% of all COVID-19 cases around the country. As of Jan. 20, the CDC estimates that's now up to approximately 86%.

"Most likely, if you're getting COVID right now, you're getting this particular variant mutation," Eyal Oren, a director and professor of epidemiology at the School of Public Health at San Diego State University, told NPR.

Oren added that one of the reasons for the latest surge is that the virus continues to evolve so rapidly that "our immune systems have not been able to keep up."

Another reason is that "not enough Americans are vaccinated," according to the CDC. Earlier this month, only 11% of children and 21% of adults were reported to have received the updated COVID-19 vaccine. Meanwhile, only 40% of adults age 65 and older, which are the highest risk group, have gotten the updated vaccine in the last year.

The CDC says COVID-19 vaccines can reduce severe illness and hospitalizations.

The low rates for COVD-19 vaccinations, along with those against influenza and respiratory syncytial virus (RSV), are of such great concern that the CDC issued an alert to health care workers last month. The combination of rising flu, RSV and COVID cases "could lead to more severe disease and increased healthcare capacity strain in the coming weeks," the agency predicted.

People may be wrongly assuming that the current COVID booster won't protect them from JN.1 or other new strains, Oren said. But the most recent vaccines from Pfizer-BioNTech, Moderna and Novavax are all expected to help lower chances of serious illness or hospitalization from JN.1.

CDC data indicates that this strain is no more severe than previous iterations, and the list of symptoms remains consistent with what they have been for COVID-19 in recent years: fever, chills, coughing, muscle aches, shortness of breath, sore throat, congestion, headaches, fatigue, and losing one's taste or smell.

Oren noted that most of the list consists of ailments that could be confused with those caused by other viruses common during winter months, including the flu, RSV or the common cold.

"That's why it's so important to get vaccinated and to get tested [for COVID], particularly if someone is at higher risk of severe outcomes," he said.

Oren urged all people, but especially those in high-risk categories, to take precautions by wearing masks, avoiding crowded places, and washing their hands. "And if you're sick stay home," he said.

The CDC reported that over the last 4 weeks, hospitalizations among all age groups increased, by 200% for influenza, 51% for COVID-19, and 60% for RSV.

The federal government offers free rapid COVID-19 tests through the mail. Four free tests can be ordered at COVIDTests.gov and will be delivered by the U.S. Postal Service.

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JN.1 takes over as the most prevalent COVID-19 variant. Here's what you need to know - NPR

CLEVELAND, Ohio The number of new COVID-19 cases in Ohio showed another marked decrease, from 9,428 last week to 7,719 this week.

It was the straight third weekly decrease, and the second time case numbers were below 10,000 since November.

Previously, case numbers saw 10 weeks of steady gains that ended the last week of 2023.

At least 1,249,751 Ohioans have received the updated one-dose COVID-19 vaccine, an increase of 15,378 people from the prior week, the state reported. This represents 10.6% of the states population.

The total COVID-19 case count since early 2020 in Ohio has reached 3,690,684.

There were 338 Ohioans newly hospitalized in the last week, raising the total since the beginning of the pandemic in 2020 to 149,160. There were 22 people admitted into the ICU, bringing the total since 2020 to 15,697.

There were also 80 Ohioans who died from COVID-19-related issues, raising the total since the beginning of the pandemic to 43,444. Death reporting sometimes lags by weeks.

Jan. 25 recap

* Total reported cases: 3,690,684, up 7,719.

* Total individuals with updated vaccine: 1,249,751, up 15,378.

* Total reported deaths: 43,444, up 80.

* Total reported hospitalizations: 149,160, up 338.

* Total reported ICU admissions: 15,697, up 22.

Jan. 18 recap

* Total reported cases: 3,682,965, up 9,428.

* Total individuals with updated vaccine: 1,234,373, up 22,689.

* Total reported deaths: 43,364, up 84.

* Total reported hospitalizations: 148,822, up 366.

* Total reported ICU admissions: 15,675, up 30.

Julie Washington covers healthcare for cleveland.com. Read previous stories at this link.

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Weekly COVID-19 cases fall for third week: Coronavirus update for Thursday, Jan. 25 - cleveland.com

Babies born to mothers who contracted a COVID-19 infection while pregnant have “unusually high rates” of respiratory distress at birth or shortly after, a Nature Communications study found.

While studies have shown contracting COVID during pregnancy has been associated with adverse outcomes for both mothers and newborn babies, the authors of the study found there is growing concern for longer-term consequences for babies after they are born.

Previous studies found there were risks of maternal hypoxia and multiorgan failure, which may lead to premature delivery, as well as stillbirth and neurodevelopmental issues — but the recent study found that if a mother is exposed to COVID, it may inflame a newborn’s airway and lead to slower breathing rates, pale or blueish skin, flaring nostrils or a retraction of the chest with each breath.

While the study finds the virus creates an increased risk for respiratory issues for babies after birth, the risk of a mother transmitting the COVID-19 virus in utero remains low.

More than 200 women with COVID-19 were enrolled in the study in Los Angeles. None of the babies tested positive for the infection at birth, but about 17 percent were diagnosed with respiratory issues, which is higher than average for newborns.

Infants who were experiencing respiratory distress stayed in the hospital for about 24 days, Dr. Olivia Man, the study’s author, told NBC News, who first reported on the study.  

The point of time the mother contracted COVID during the pregnancy did not have an impact on whether the infant experienced respiratory distress.

Vaccination played a part in the study’s results. Unvaccinated mothers had three times the odds of respiratory distress in their babies compared with mothers who had at least one dose of the COVID vaccine.

If a mother contracts the infection, her body will produce more cytokines, which are involved in the body’s immune response and trigger inflammation. Inflammation in the mother may activate inflammation cells in the infant.

Man told NBC News that the doctors believe the COVID infection in the mother will cascade from the mother to the infant, who is “responding to their mother’s own inflammation.” Long-term consequences are not known yet, but Man said it could include asthma.

Not all mothers who contract COVID while pregnant will experience negative outcomes with their babies.

The Centers for Disease Control and Prevention said it is safe for a pregnant mother to receive the COVID vaccine at any point in the pregnancy, and it helps build antibodies that will protect the baby from contracting the virus.

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Study links COVID-19 infections in pregnant women to respiratory health issues in babies - The Hill

The results show COVID shots in pregnancy can offer protection, researchers say.

January 26, 2024, 6:25 PM ET

5 min read

Unvaccinated pregnant people who contracted COVID-19 were more likely to have babies who suffered from respiratory distress, a new study published this week found.

A team of researchers led by the University of California, Los Angeles, looked at 221 pregnant people for the study, including 151 who were unvaccinated before they were infected with COVID, which was confirmed with a laboratory test.

All of the 151 unvaccinated pregnant people met the National Institutes of Health criteria for severe or critical COVID-19 whereas only 4% of the 70 vaccinated pregnant people met the criteria.

Researchers were able to examine 199 babies, all of whom were born between April 2020 and August 2022, and none of whom tested positive for the virus. The remaining 28 fetuses either resulted in a miscarriage, abortion or fetal demise, or could not be followed up with.

The team found that being exposed to COVID-19 in utero "may activate an inflammatory cascade" in the airways of newborns, resulting in respiratory distress. One of the main pathways appear to be associated with the function of cilia, the tiny, hair-like structures found on the surface of cells that typically help push germs, mucus and other particles towards the mouth so they can be coughed or sneezed out.

Results, published in the journal Nature Communications, found the odds of respiratory distress were up to three times greater in babies born in those who were unvaccinated versus those who were vaccinated.

"We found unusually high rates of respiratory distress shortly after birth in the full-term babies born to mothers who had COVID-19 during pregnancy," Dr. Karin Nielsen, a professor of pediatrics in the division of pediatric infectious diseases at UCLA's David Geffen School of Medicine, said in a statement. "The mothers had not been vaccinated prior to acquiring COVID, indicating that vaccination protects against this complication."

Further research is needed to determine if COVID-19 still impacts respiratory distress when accounting for other factors that lead to respiratory distress syndrome

Respiratory distress in infants is defined as difficulty breathing or working harder to breathe within the first 24 hours. Signs can include wheezing, sweating, changes in breathing rate or color changes around the lips or mouth, according to Johns Hopkins Medicine.

Research has shown that pregnant people with COVID-19 are at increased risk of becoming seriously ill leading to hospitalization, intensive care, the use of a ventilator or even death. COVID-19 during pregnancy also raises the risk of a premature or stillborn baby.

"Our results demonstrate that maternal vaccination against COVID-19 not only protects against maternal disease severity, but also reduces the likelihood of neonatal [respiratory distress]," the authors wrote.

The study had several limitations, such as a small and homogenous sample size and a wide estimate range, which impacted generalizability. More research is needed to validate these findings.

The Centers for Disease Control and Prevention (CDC) currently recommends that all pregnant people get vaccinated against COVID-19 and that studies have shown there are no safety concerns for babies born to those who have been vaccinated.

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Babies born to unvaccinated people who had COVID-19 may be at greater risk of respiratory distress: Study - ABC News

"COVID is here to stay," emphasized World Health Organization (WHO) Regional Director for Europe, Hans Kluge, MD, at a press briefing on January 16, 2024. He stressed the need for continuing vigilance and efforts to keep the disease at the top of the political and healthcare agendas, while attention may be drifting to other major global events.

The WHO estimated that COVID-19 vaccines have saved at least 1.4 million lives in the WHO European Region, which encompasses 53 countries across a broad geographical area including the European Union (EU) and countries like Russia and Israel. Kluge said that at present, COVID-19 rates "remain elevated but are decreasing." However, he emphasized that the region is seeing widespread circulation of other respiratory viruses, including influenza, respiratory syncytial virus, and measles. The WHO was concerned that health services should prepare for an upsurge in the full range of respiratory virus hospitalizations in the next few weeks.

Kluge said that the unpredictable nature of the SARS-CoV-2 virus means that the emergence of new variants could cause the current situation to rapidly worsen.

Edoardo Colzani, MD, the Principal Expert on Respiratory Viruses at the European Centre for Disease Prevention and Control (ECDC), told Medscape Medical News that in the EU and European Economic Area, "Countries report a mix of increasing and decreasing trends in SARS-CoV-2 activity, COVID-19 hospitalizations, and ICU admissions and deaths, with severe outcomes predominantly among those aged 65 years and above."

The ECDC monitored the results of COVID-19 tests in selected sentinel sites chosen to give a representative sample. The percentage of positive tests in primary care sites increased from week 44 to week 49 of 2023 but fell since week 50.

Colzani said that many countries also conduct testing at non-sentinel sites, such as hospitals, schools, primary care facilities, laboratories, and nursing homes. "At the EU and EEA level, SARS-CoV-2 detections and testing in non-sentinel data were similar to those reported for sentinel data, with most countries reporting decreasing trends. However, in some countries, SARS-CoV-2 positivity and detections in non-sentinel data are notably increasing, especially in those aged 65 years and above," he explained.

Despite a decreasing trend in COVID-19 across Europe overall, data from the WHO reported an increasing trend in SARS-CoV-2 positivity in four EU reporting countries in the second week of January: Poland, Portugal, Switzerland, and Slovakia.

In terms of disease severity, Colzani said, "We wouldn't go as far as saying that there is declining severity, but surely it's not increasing...But if [vaccination] is not kept up to date, then we may see an increase in severity due to waning immunity, particularly among groups at risk."

The data available collectively from the ECDC and WHO revealed a complex picture of increasing and decreasing trends, covering rates of positive testing, hospital admissions, intensive care unit (ICU) admissions, and COVID-19associated deaths. The values were changing significantly from week to week.

In terms of death rates, the WHO stated that although levels remained relatively low in the second week of January, Malta reported a marked increase in COVID-19 death rates in people aged 65 years and older, while 10 of the 14 countries reporting age-specific death data documented a marked decrease.

"Member States should be ready for the possible need to increase emergency department and ICU capacity, in terms of adequate staffing and bed capacity, for both adult and pediatric hospitals," said Colzani. "Hospital administrators and managers should ensure that resources, such as medical and nursing staff and equipment, are also available."

As the virus continues to evolve, the ECDC view, generally shared by the WHO, is that there are currently no new variants of concern, but there are some variants of interest that are being closely monitored. "JN.1, which is a sub-lineage of the BA.2.86 variant, has been particularly increasing in proportion recently, but without so far causing a visible impact on the epidemiological indicators," said Colzani.

The prevalence of the diverse range of issues characterized as long COVID is another major aspect of the disease. The WHO estimated that 36 million people across the WHO European region may have developed long COVID over the first 3 years of the pandemic.

Several speakers at the WHO briefing highlighted lessons learned from the pandemic to help prepare for future ones, including the importance of regional resilience, with nations and regions needing to become self-sustainable in the manufacturing of medical and other supplies and in conducting clinical trials.

Looking to the future, Catherine Smallwood, MD, COVID-19 Incident Manager of WHO/Europe, told the press briefing, "We are workingin the European region and beyond to revise and update pandemic plans [to ensure] that what we've experienced in the last pandemic can be documented and included in the pandemic plan for the next one."

Hans Kluge concluded, "It's so important [to get] an international agreement, a pandemic accordto tackle some issues like much quicker exchange of information, of data on clinical trials, and of sharing also the different medical countermeasures."

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Picture of COVID-19 in Europe Is Complex - Medscape

LOT OF RESPIRATORY ILLNESSES. AND ONE DOCTOR I SPOKE WITH SAYS THEYRE SEEING MORE PATIENTS COMING IN NOW AS THESE COVID AND FLU CASES ARE PEAKING FOR THE SEASON. ACCORDING TO THE STATE DEPARTMENT OF HEALTHS MOSTRILLIONECENT WEEKLY REPORT, SOUTHEASTERN WISCONSIN IS SEEING HIGH LEVELS OF FLU LIKE ILLNESS. A TYPICAL FLU SEASON MEANS A LOT OF FOLKS GET SICK. IT MEANS A LOT OF PEOPLE GET HOSPITALIZED. AND, UM, AND SO THIS IS REALLY THE PEAK OF THE SEASON THAT WERE SEEING RIGHT NOW. DOCTOR BENJAMIN WESTON SAYS THAT PEAK ALSO COMING FOR COVID CASES AND THE IMPACT OF THE ILLNESSES ARE FELT BY THE MILWAUKEE COMMUNITY. THERE IS YEAH, TOO MANY PEOPLE. THEY ARE SICK AND COUGH. SAME THING TO AND A LITTLE BIT FEVER. ALVINA SCHICK IS A TEACHER WHO DODGED THE VIRUS SO FAR, BUT SHES SEEING INCREASED CASES AMONG HER STUDENTS. IT IS AROUND COUGHING, SNEEZING. THATS WHY I ALWAYS ASK MY STUDENTS, PLEASE USE HAND SANITIZER. MAKE SURE YOU STEP BACK IF YOU SOMEBODY IS PASSING BY, YOU AND AND TO BE VERY SAFE, WEAR A MASK. THE STATES WEEKLY REPORT SHOWS THAT COVID IS SENDING MORE PEOPLE 65 AND OLDER TO THE EMERGENCY ROOM WITH THE FLU, SENDING PEOPLE 17 AND YOUNGER TO THE E.R. THE HOSPITALIZATIONS ARENT AT A CRITICAL LEVEL, ACCORDING TO DOCTOR WESTON, AND HE SAYS THERE COULD BE RELIEF IN THE NEAR FUTURE. SO HOPEFULLY IN THE COMING WEEKS, WELL SEE A DECLINE IN THESE SORT OF VIRAL RESPIRATORY ILLNESSES. BUT RIGHT NOW THEYRE AT A PRETTY HIGH LEVEL. ERICA DOCTOR WESTON SAYS THERE ARE TWO THINGS PEOPLE CAN DO RIGHT NOW TO HELP STOP THE SPREAD. THATS RIGHT. HE SAYS THAT EITHER YOU COULD STAY HOME IF YOU

'Peak of the season': Wisconsin DHS reports high flu, coronavirus levels

Milwaukee County's chief health policy director says they're seeing more patients because of respiratory illnesses, but hospital capacity is not at critical level

Updated: 10:40 PM CST Jan 25, 2024

Wisconsin State Department of Health's most recent weekly respiratory virus surveillance report shows high rates of influenza and coronavirus in the southeastern region.According to Dr. Benjamin Weston, Milwaukee County's chief health policy advisor, these viruses are hitting their peak: "A typical flu season means a lot of folks get sick. It means a lot of people get hospitalized and so this is really the peak of the season that we're seeing right now."Multiple people WISN 12 News spoke with said they're feeling that impact, including Marwan Atshan who recently had a flu-like illness."There is, yeah, too many people," Atshan said. "They are sick and cough. Same thing too, and little bit fever."Alveena Sheikh is a teacher who's dodged the viruses so far, but she's seeing increased cases among her students."Coughing, sneezing. That's why I always ask my students, please use hand sanitizer," Sheikh said. "Make sure you step back if somebody is passing by you and to be very safe, wear a mask."The state's weekly report shows that coronavirus is sending more people 65 and older to the emergency room with the flu sending 17 and younger to the emergency room.Hospitalizations aren't at a critical level, according to Weston, and he expects there could be relief in the near future."So hopefully, in the coming weeks, we'll see a decline in these sort of viral respiratory illnesses. But right now, they're pretty high level," Weston said.While it's far into the respiratory illness season, Weston said it's not too late to get the vaccines, especially for those who are immunocompromised. The doctor recommends people who are sick stay home to prevent the spread.

Wisconsin State Department of Health's most recent weekly respiratory virus surveillance report shows high rates of influenza and coronavirus in the southeastern region.

According to Dr. Benjamin Weston, Milwaukee County's chief health policy advisor, these viruses are hitting their peak: "A typical flu season means a lot of folks get sick. It means a lot of people get hospitalized and so this is really the peak of the season that we're seeing right now."

Multiple people WISN 12 News spoke with said they're feeling that impact, including Marwan Atshan who recently had a flu-like illness.

"There is, yeah, too many people," Atshan said. "They are sick and cough. Same thing too, and little bit fever."

Alveena Sheikh is a teacher who's dodged the viruses so far, but she's seeing increased cases among her students.

"Coughing, sneezing. That's why I always ask my students, please use hand sanitizer," Sheikh said. "Make sure you step back if somebody is passing by you and to be very safe, wear a mask."

The state's weekly report shows that coronavirus is sending more people 65 and older to the emergency room with the flu sending 17 and younger to the emergency room.

Hospitalizations aren't at a critical level, according to Weston, and he expects there could be relief in the near future.

"So hopefully, in the coming weeks, we'll see a decline in these sort of viral respiratory illnesses. But right now, they're pretty high level," Weston said.

While it's far into the respiratory illness season, Weston said it's not too late to get the vaccines, especially for those who are immunocompromised.

The doctor recommends people who are sick stay home to prevent the spread.

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'Peak of the season': Wisconsin DHS reports high flu, coronavirus levels - WISN Milwaukee

Chief Minister M.K. Stalin on Thursday alleged that the BJP government at the Centre has not done anything good for the people of Hindi-speaking States despite them voting substantially for the party.

It (Central government) is imposing Hindi on non-Hindi speaking States only to deceive the Hindi-speaking population. Have they done anything worthwhile for them? Mr. Stalin asked while addressing a meeting organised on the occasion of the Linguistic Martyrs Day in Chennai.

Mr. Stalin said people of Hindi-speaking States underwent untold miseries during the pandemic as they could not get transport facilities to return to their hometowns. We had shed tears for them. They walked hundreds of kilometres. Some of them were even crushed by trains. If something is more dangerous than the Corona (virus), it is the BJP government. Now the government is trying to divert peoples attention by consecrating the Ram temple, he said.

Recalling a viral video in which a Hindi-speaking boy demanded education over temple, the Chief Minister said the BJP government was particular that people should not gain awareness. The people of north India are no longer ready to believe the politics of the BJP. It cannot win in northern States in the forthcoming Lok Sabha polls, Mr. Stalin said.

He also said the resolution adopted in the youth wing conference of the DMK in Salem, which vowed to expose the BJP, the enemies of the Hindus should be carried out as a campaign by everyone. BJP has taken refuge in religion to save its skin. We should expose its failures and its anti-Tamil policies to save India, he added.

Training his guns on AIADMK leader Edappadi K. Palaniswami, Mr. Stalin alleged that the former Chief Minister, who played second fiddle to the BJP government and supported its anti-people policies, also connived with the partys anti-Tamil stand. He did not oppose the GST and plunged the State into a financial crisis. He helped in the imposition of Hindi, and was eventually rejected by the people of Tamil Nadu, he said.

Reiterating that the victory of the INDIA bloc in the Lok Sabha polls alone could ensure a future for India, he said a government led by the bloc would be truly federal in nature.

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BJP is more dangerous than Coronavirus, says Stalin - The Hindu

If we all went a little nuts during the COVID-19 lockdowns, it's absolutely true that some of usincluding many of our country's leaders and people in the mediawent absolutely batshit crazy, often with disastrous results.

Exactly why that happened is the subject of author Jon Ronson's latest season of Things Fell Apart, a podcast that explores the deep origins of today's culture wars in controversies, panics, and delusions from decades ago.

Reason's Nick Gillespie talkedwith Ronson about why he believes the creation of a fake medical condition called "excited delirium" in 1988 ultimately led to the death of George Floyd in 2020, how law enforcement fixations on white supremacy warped the investigation into a plot to kidnap Michigan Gov. Gretchen Whitmer, and how the director of the massively influential Plandemic documentaries was actually rewriting the script of Star Wars.

Ronson is best known as the author of The Men Who Stare at Goats, an account of a U.S. Army unit that tried to perfect paranormal powers like walking through walls, and So You've Been Publicly Shamed, which helped define cancel culture just as it was becoming widespread via social media.

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Why We Went Crazy During COVID-19 Lockdowns - Reason