Category: Corona Virus

By A.J. Hostetler

A simple, widely used test developed by a Virginia Commonwealth University researcher to predict advanced liver disease can also predict which COVID-19 patients might need a respirator, with patients higher on the scale almost twice as likely to need help to breathe.

In the Journal of Clinical and Translational Science, VCU researchers report their analysis of more than 232,000 hospitalized adults across the country who tested positive for the COVID-19 virus. Regardless of the variant of the virus, patients with higher levels on the FIB-4 index were more likely to end up on a respirator.

Patients infected with the initial SARS-CoV-2 virus that sparked the COVID-19 pandemic have a higher rate of respiratory failure, but recent variants are less likely to lead to hospitalization. Studies earlier in the pandemic hinted that the Fibrosis-4 index might also help evaluate COVID-19 patients. This new analysis dives deeper, exploring the role of the FIB-4 index in understanding risk factors and guiding treatment decisions over the COVID-19 variants.

FIB-4 stands the test of time and continues to find new applications, said Richard Sterling, M.D., chief clinical officer of VCUs Stravitz-Sanyal Institute for Liver Disease and Metabolic Health, the lead for clinical and translational science pilot programs at VCUs C. Kenneth and Dianne Wright Center for Clinical and Translational Research, and the studys corresponding author.

By incorporating measurements such as a patients age, liver enzymes and platelet count, the FIB-4 index can judge the severity of a patients liver disease. In the early 2000s, Sterling developed the index, now considered the gold standard worldwide as the initial screening test for most liver diseases. The FIB-4 index is a simple test recommended by leading liver, gastroenterology and endocrinology societies as a first-line test to screen for liver fibrosis.

The analysis in the current study sought to determine whether the FIB-4 index would be a useful tool related to newer variants of the coronavirus, including alpha, delta and the more recent omicron. The researchers reviewed data on 232,364 hospitalized patients, ages 1890, who tested positive for COVID-19 between April 27, 2020, and June 25, 2022, as part of the National COVID Cohort Collaborative.

The primary objective was to investigate the association between the FIB-4 index and the need for respiratory support, which often precedes a patients death. Additionally, the study explored the relationship between index measurements and the likelihood of a patients death within the first 30 days after falling ill.

The FIB-4 index was notably accurate, particularly during the wave of the delta variant, when the index had a 97% success rate in predicting those who would not need respiratory support and strongly associated in those who would.

Overall, regardless of the COVID-19 variant, patients with increased FIB-4 levels were 1.8 times more likely to require a respirator to breathe for them.

Even when adjusting for other health factors like diabetes, cardiac issues, respiratory disease and obesity, the FIB-4 indexs reliability remained valuable in differentiating between patients with multiple illnesses who may require respirators and those who are less likely to need such intervention.

The power of the FIB-4 index also helped predict whether patients would survive more than a month. Patients across the different virus variants who had elevated FIB-4 levels faced an increased risk of dying within 30 days after falling ill. (The review found that 25,250 patients died in that period.) This implies that the FIB-4 index serves as a holistic indicator of a patients overall health and prognosis.

As the COVID-19 pandemic continues, and as the virus evolves in transmissibility, severity, symptoms and response to vaccines, the FIB-4 index has emerged as a valuable tool for understanding patients risks for future variants and as a simple tool for front-line providers to help identify respiratory disease severity from COVID-19.

This project was supported in part by the Biostatistics, Epidemiology and Research Design core of the C. Kenneth and Dianne Wright Center for Clinical and Translational Research (award No. UL1TR002649 from the National Center for Advancing Translational Sciences).

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A tool in battling COVID-19: Simple liver test developed by VCU researcher is highly predictive of a patients need for ... - VCU Health

The investigation of virus tenacity in the environment plays a crucial role in enhancing our understanding of potential transmission routes for infectious diseases. Our study focused on assessing the tenacity of airborne FCoV and FCoV in dried organic matrices on surfaces. Overall, airborne FCoV showed a remarkable level of stability over a wide range of RH conditions. However, it is important to note that relative humidity has an impact on FCoV stability. The virus showed higher stability at both low and high RH levels, whereas medium RH conditions (around 5060%) were associated with a higher probability of decay. Remarkably, FCoV remained infectious for over 7h in the airborne state at medium RH levels. Moreover, on surfaces, FCoV showed the ability to remain infectious for extended periods, even up to several months. The stability on surfaces was influenced by factors such as temperature and the presence of organic material.

FCoV was used as a surrogate for SARS-CoV-2 in our study. Working with infectious pathogens of biosafety level 3 (SARS-CoV-2) is only possible in a limited number of laboratories, and especially with virus aerosols, it is very challenging. FCoV, on the other hand, can be studied under biosafety level 2 (BSL2) conditions, making it a safer and more cost-efficient option. FCoV belongs to the genus Alphacoronavirus, while SARS-CoV-2 is a Betacoronavirus. Although they share only 44.044.5% similarity at their nucleotide level3, previous research has shown that non-zoonotic animal coronaviruses like FCoV, canine coronavirus (CCV), transmissible gastroenteritis virus (TGEV) or mouse hepatitis virus (MHV) could be a suitable surrogate for survival of zoonotic SARS-CoVs27,28,29. To the best of our knowledge, this is the first study investigating the tenacity of FCoV in aerosols and on surfaces.

Our aerosol experiments were conducted in an aerosol chamber with a volume of 7m3, allowing individual airflows and climatic conditions. The chamber has been previously utilized in a study investigating the stability of Escherichia coli in aerosols30. Other studies investigating pathogen stability in aerosols, including SARS-CoV-2, have utilized a rotating drum, as described by Goldberg et al.14,31, to generate a dynamic aerosol. Our chamber offers a good opportunity to create a more realistic setting for exploring pathogen behavior within a room. To investigate FCoV stability, we worked with both dynamic (air exchange) and static (no air exchange) aerosol setups.

We observed a slight U-shaped trend in the stability of FCoV in dynamic aerosols at different RH levels, indicating that FCoV was more likely to decay at medium RH levels, ranging from 50 to 60%. This U-shaped pattern has also been observed for other enveloped viruses, including TGEV and influenza virus32,33. However, studies on human coronaviruses have shown varying results. For example, Sars-CoV and MERS have been found to be more stable at medium humidity levels34,35. Oswin et al. demonstrated that at low humidity levels, the initial stability decreases significantly but then remains relatively stable compared to higher humidity levels. If this initial decrease is neglected, a U-shaped pattern could also be observed21. Overall, coronaviruses in the aerosol state appear to be more stable than influenza or filoviruses at medium humidity levels34. When comparing studies on stability of viruses at different humidity levels, it is important to consider the medium used, as significant differences in stability can arise due to this factor. The most important fact to take into consideration when talking about the relationship between stability of viruses and RH is the microenvironment of the droplet and therefore the medium in which it resides36. Simulating human respiratory fluids accurately is still challenging due to the unknown exact components and concentrations. Therefore, many studies used cell culture medium such as DMEM as a model medium. One previous study compared DMEM with porcine respiratory fluid (PRF) and found that they differed greatly in the NA:K ratio. In addition, PRF contained significantly more protein37. It is important to note that studies using simulated respiratory fluids or real respiratory fluids instead of model medium have shown differences in virus stability38. These studies suggest that virus stability might be underestimated in most cases34,36,39,40. To make studies more representative, changes should be made to the virus suspension medium in further aerovirology studies37.

In our study, we modified DMEM by supplementing it with 10% FBS as a protein source, as respiratory droplets contain a variety of salts and proteins41,42. Yang et al. investigated the influence of different model media on the stability of Influenza A viruses in droplets, comparing DMEM and PBS, each with or without the addition of 5% FBS as a protein source. In general, they found better viability in DMEM than in PBS especially at medium and low RH36. Notably, the addition of FBS significantly affected virus stability at medium RH levels, suggesting a protective effect of proteins43,44. When a droplet leaves the respiratory tract, it evaporates by approximately half its original size depending on the ambient RH. This leads to a high concentration of substances within the droplet, such as salts, which are usually harmless but can become toxic to the virus. This effect is only relevant at medium RH levels just before the salts crystallize36. The exact RH at which the salts crystallize (efflorescence RH) depends on the droplet's composition and medium45. These findings support our own observations, as we observed a slight decrease in stability at medium RHs in the aerosol. Overall, we observed a high stability of FCoV in the aerosol, likely due to the presence of 10% FBS. The dynamic aerosol setup aimed to simulate a ventilated room where a virus emitter is present. The results indicate that the ambient RH in a room can significantly impact the stability of the emitted virus in the aerosol and thus its transmission potential. To minimize the risk of infection, it is advisable to keep the relative humidity at medium levels in indoor places.

Furthermore, our study demonstrated that FCoV remained infectious in static aerosols for over 7h with a half-life of 34.8min. The static aerosol setup aimed to simulate an enclosed room without regular air exchange, where a virus was released for a specific duration. During these experiments, we considered the possible natural loss of virus due to sedimentation. We observed a 31.4% loss of infectious virus through sedimentation, which occurred within the initial 10min and was than constant over the subsequent 7h. Moreover, the particle count remained stable throughout the entire experiment, indicating that virus-containing particles relevant for aerosol transmission remained suspended in the aerosol. It is known that aerosol particles <5m, which are relevant for inhalation, remain suspended as droplet nuclei in the air for hours, while larger droplets >10m settle to the ground within minutes due to gravity11,12,46. However, re-aerosolization of these sedimented infectious virus particles may also occur. In these experiments, the RH averaged 33%. Previous studies on related viruses have found that SARS-CoV-1 and SARS-CoV-2 remain stable in aerosols for over 3h, with respective half-lives of 1.1 and 1.2h, at an RH of 65%14. Similarly, MERS-CoV was found to be infectious in aerosols for over 3h35. In our study, we observed that FCoV has a half-life of 34.8min in aerosols and was detectable for over 7h. There was one other research group that investigated the stability of SARS-CoV-2 in aerosols over a longer period and found infectious virus after 16h at an average RH of 53%. However, this was a single observation without replication18. Comparing the half-lives of SARS-CoV-2 and FCoV indicates that both exhibit relatively short durations, suggesting similar behavior in aerosol stability. Observed differences may be more likely attributed to different aerosol generation processes and sampling methods. When considering influenza A viruses, their infectivity in aerosols varies lasting from 1 to 24h, depending on RH levels. Furthermore, influenza A viruses adapted to animals tend to demonstrate longer stability compared to human influenza A viruses47,48. It is important to note that comparisons between these studies are challenging due to variations in RH levels and medium used, as both factors strongly influence the stability of airborne viruses, as mentioned earlier. In general, our findings underscore the potential risk of aerosol transmission of enveloped respiratory viruses, especially in enclosed and unventilated environments over an extended period. This aligns with previous studies that have demonstrated aerosol transmission of SARS-CoV-2 between animals using hamsters as an animal model49,50.

At optimal environmental conditions the recovery rate of airborne FCoV was approximately 13% in our study. Several factors may have an influence on recovery rates of airborne viruses, including inactivation during aerosolization, loss through sedimentation, as well as sampling losses. We assume that our ultrasonic nebulizer and the aerosilization settings used resulted in the production of a suitable viral aerosol. In a study by Kim et al. various nebulizers and settings like pressure and nebulization time were tested to evaluate their impact on the stability of TGEV, and it was concluded that the stability of TGEV was not significantly affected32. Dhla et al. emphasized the importance of selecting an appropriate sampling method, as it can influence the stability of viruses in the sample. Since there is no generally recommended virus air sampling method, the choice of air sampler needs to be individually determined based on the specific experimental setup51. Most commonly used air samplers for collecting SARS-CoV-2 include filters, impactors, cyclone samplers and impingers52. For our experiments we chose the Coriolis cyclone air sampler. Previous studies aiming to detect SARS-CoV-2 in hospitals or healthcare settings have also utilized cyclone samplers due to their high collection volume53,54,55,56. While SARS-CoV-2 RNA has been detected in these studies, the identification of infectious SARS-CoV-2 was reported in only a few cases. It should be noted that cyclone samplers may be less efficient in detecting low levels of viruses compared to other air samplers, as the centrifugal forces affecting the viruses during collection could potentially cause stress57. However, in our study, we worked with high concentrations of viruses in a controlled environment, which made the Coriolis sampler suitable for our purposes, and we were able to detect infectious viruses.

We observed that 31.4% of the infectious virus sedimented onto the ground or surfaces within the first 10min in the static aerosol. This finding highlights the potential risk of contact transmission and the importance of studying virus infectivity on commonly encountered surfaces. We focused on stainless steel surfaces, which are frequently found in public buildings and clinical settings and are frequently touched. Previous studies have shown that CoVs exhibit greater stability on non-porous surfaces like metal, glass or plastic compared to porous surfaces, such as paper or fabrics58,59. Furthermore, viruses tend to be more stable at lower humidity levels and temperatures59. In our study, we demonstrated that FCoV remained infectious for 1958days at 20C and low RH, with the organic load significantly influencing the virus's stability. Comparatively, SARS-CoV-2 remained infectious on stainless steel surfaces for 47days at room temperature, while MERS and Sars-CoV-1 remained infectious for 2days14,15,35,60,61. TGEV and MHV, other non-zoonotic CoVs, remained infectious at room temperature for 3days at 50% RH and up to 28days at 20% RH27. It is important to note that differences in the results of various studies may occur due to varying medium used. While most of these studies were conducted using cell culture medium, we enriched our medium with 10g/L yeast extract/BSA or 3g/L sheep blood/BSA, representing a high organic load according to the guidelines for virus inactivation studies on nonporous surfaces62. Exhaled droplets that would sediment on surfaces consist of respiratory tract residues, saliva and organic material from the environment, resulting in a high organic load. Other studies added a tripartite soil load (mucin, BSA and tryptone) following international standard ASTM to the medium and found increased stability of SARS-CoV-2 on stain-less steel surfaces at 20C for 1428days, indicating a protective effect of the organic load16,63. Therefore, we would suggest using a high organic load, such as ASTM Internationals standardized tripartite soil load64, for further studies to avoid underestimating the stability of these viruses in the environment. However, it should be taken into consideration that stability may differ in dried human respiratory fluids. Regarding the influence of temperature, we found that infectious FCoV was detectable at 4C and 50% RH for 54167days, depending on the organic load. Only few studies have investigated CoVs stability at temperatures below 20. Notably, Onianwa et al. observed a reduction in infectiousness of the Delta variant of SARS-CoV-2 at 24C and 65% RH in the first 2.5h, while no reduction was observed at 4C and 85% RH within 2.5h65. TGEV and MHV also remained infectious at 4C for over 28days at all tested RHs, with the lowest losses observed at 20% RH27. Interestingly, we observed prolonged infectivity with yeast extract at 4C, although the reason for this difference remains unclear.

Like in aerosols, evaporation, and thus RH, plays an important role in terms of virus stability in droplets that sediment. French et al. studied the interplay of droplet volume and RH on surfaces and found that loss of infectivity was slower and more affected by RH in larger droplets (50L) than in small droplets (1L)66. Studies investigating stability of CoVs on surfaces, including our study, all used larger droplet volumes, which are not in line with realistically expelled droplet volumes (<0.5L) and may lead to different conclusions about virus stability. Another limitation of our study design is that we could not regulate the RH at the storage place and therefore could not distinguish between the influence of temperature and RH after drying. However, French et al. found that that viral decay during the wet phase was higher than during the dry phase regardless of RH66. In our experiment, all germ carriers were dried under controlled conditions for 45min, allowing us to neglect the influence of RH during the wet phase. Thus, the observed differences in stability may be primarily attributed to temperature and variations in organic load.

In summary, our study demonstrated that FCoV could remain infectious in the airborne state for hours and on surfaces up to months, with the duration depending on environmental conditions. Factors such as RH, temperature, and the presence of organic material significantly impact the pathogen's infectivity outside the host. Comparing studies on virus stability is challenging due to the lack of standardized experimental setups and medium used in these investigations. Additionally, reproducing respiratory fluids in the laboratory is difficult as their exact composition is still unknown. However, existing evidence suggests that viruses may exhibit even greater stability in respiratory fluids. It can be stated that aerosol transmission as well as droplet and contact transmission are possible transmission routes for coronaviruses under various environmental conditions over an extended period. Whether an infection occurs depends on many other factors, such as the viral load in the environment, the minimum infection dose,and the immune state of individuals. Especially enclosed, poorly ventilated rooms and low RH environments may pose a higher risk of infection due to the accumulation and better stability of these enveloped viruses. Given that, different pathogens respond uniquely to environmental conditions based on their biological and physical properties, it is essential to study a wide range of viruses to identify and understand potential correlations. The exact mechanisms that lead to the inactivation or protection of enveloped viruses by environmental components remain unknown and require further research. Our study suggests that FCoV could be a valuable surrogate for studying the behavior of zoonotic coronaviruses like SARS-CoV-2 in the environment. Although surrogates could offer valuable insights into the stability and persistence of these viruses outside the host, enhancing our understanding of zoonotic transmission dynamics, it remains crucial to directly investigate the actual virus.

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Stability of Feline Coronavirus in aerosols and dried in organic matrices on surfaces at various environmental ... - Nature.com

BYLINE: Mario Boone

Newswise Rockville, Md. (December 12, 2023)Lung airway cells of people with alcohol use disorder developed enhanced inflammation three days after being infected with SARS-CoV-2, the virus that causes COVID-19, according to a new study from Emory University School of Medicine in Atlanta and the University of Georgia.

An analysis of gene expression found that uninfected airway cells from people with alcohol use disorder (AUD) had mild pro-inflammatory characteristics that were amplified after SARS-CoV-2 infection when compared to cells not exposed to excessive alcohol use (control). In addition, control cells infected with the virus showed a protective response not seen in the AUD cells. The findings are published in the American Journal of Physiology-Lung Cellular and Molecular Physiology. It has been chosen as an APSselect article for December.

To achieve their findings, researchers isolated cells from the inside of the airway of people with and without alcohol use disorder. Next, the cells were cultured to create a model airway epithelium. Gene expression was analyzed by next-generation RNA sequencing to measure the effect of chronic alcohol exposure on airway cells. The research team then infected the cells with SARS-CoV-2 and measured the production of inflammatory factors.

People with alcohol use disorder who also have COVID-19 have higher rates of hospitalization and death. This indicates that chronic alcohol use puts people at risk for increased severity of COVID-19-related illness. By conducting this study, Michael Koval, PhD, of Emorys Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, and his team determined that alcohol abuse causes lung airway cells to over-react to SARS-CoV-2 infection, which may increase the severity of early stages of COVID-19.

Read the full article, Chronic alcohol use primes bronchial cells for altered inflammatory response and barrier dysfunction during SARS-CoV-2 infection. It is highlighted as one of this months best of the best as part of the American Physiological Societys APSselect program. Read all of this months selected research articles.

NOTE TO JOURNALISTS: To schedule an interview with a member of the research team, please contact APS Media Relations or call 301.634.7314. Find more research highlights in our Newsroom.

Physiology is a broad area of scientific inquiry that focuses on how molecules, cells, tissues and organs function in health and disease. The American Physiological Society connects a global, multidisciplinary community of more than 10,000 biomedical scientists and educators as part of its mission to advance scientific discovery, understand life and improve health. The Society drives collaboration and spotlights scientific discoveries through its 16 scholarly journals and programming that support researchers and educators in their work.

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Alcohol Abuse Increases Sensitivity of Coronavirus Infection - Newswise

Website Last Updated 3:01 PM 12/6/2023 Data shown as of previous day at 11:59 pm PT.

These dashboards show trends in Washington state for COVID-19, influenza (flu), and respiratory syncytial virus (RSV). The data on these dashboards help us monitor early signs of disease spread, severity of illness, vaccination rates, virus variants or subtypes occurring in Washington, and hospital bed use due to COVID-19, flu, and RSV.

Instead of showing data by individual counties, these dashboards use larger regional areas calledAccountable Communities of Health (ACH).This change was made because sometimes there is not enough data reported from the county level to display publicly while maintaining an individuals privacy.See which ACH region covers your county.

Additional COVID-19 hospital admission data at the county level is available in theCDC COVID Data Tracker: Maps by Geographic Area.

Learn how to stop the spread of these illnesses by visiting ourCOVID-19,flu, and RSVpages.

Wednesday, December 6, 2023: Laboratory data for influenza is current through November 25, 2023. Death data for COVID-19, RSV, and influenza are current through November 25, 2023. All other data on this dashboard are current through December 2, 2023.

Information shown below is for the most recent week with complete data.

Every day, acute care hospitals in Washington report their COVID-19 patient occupancy to the Department of Health through WA-HEALTH, a hospital data collection system developed in partnership with the Washington State Hospital Association. The table below shows the total number of hospital beds occupied by patients with confirmed COVID-19 and influenza, and a subset of patients who occupy beds in intensive care units (ICUs). Data shown below are the most recent complete data available.

Information shown below is for the most recent week with complete data.

Information shown below is for the most recent week with complete data.

Information shown below is for the most recent week with complete data.

Information shown below is for the most recent week with complete data.

Information shown below is for the most recent week with complete data.

Information shown below is the total count of deaths with complete data. Counts below 10 are suppressed for privacy and shown as blank.

Information shown below is the total count of deaths with complete data. Counts below 10 are suppressed for privacy and shown as blank.

Information shown below is the total count of deaths with complete data. Counts below 10 are suppressed for privacy and shown as blank.

The following reports have been discontinued. Below are the final published reports.

If you have questions about our reports, email DOH-CDS-Surveillance@doh.wa.gov. If you are a member of the news media, email PIO@doh.wa.gov.

The Department of Health (DOH) provides detailed notes to help you understand the Respiratory Disease Dashboard data for COVID-19, Influenza (flu), and RSV. We present information for the following categories of data:

For each category, there may be detailed information on the data source, data lags and limitations, definitions, calculations, and additional resources and references. For more information about the Respiratory Illness Dashboard data, email DOH-CDS-Surveillance@doh.wa.gov.

Number of deaths with a date of death during the 7-day period :over:

Population

X :times: 100,000

Total positive clinical cases with a specimen collection date during a given week :over:

Population

X :times: 100,000

Adult + pediatricconfirmedCOVID-19hospitalizations over 7 days :over:

7

Adult + pediatricconfirmedCOVID-19hospitalizationsover7days :over:

Sumofstaffedhospitalbedcapacityover7days

X :times: 100

Adult + pediatricconfirmedCOVID-19 (or influenza)ICUoccupants :over:

7

Adult + pediatricconfirmedCOVID-19or influenza ICUoccupants :over:

SumofstaffedICUbedcapacityover7days

Health disparities are gaps in the quality of health and health care that mirror differences in social factors such as economic status, racial and ethnic background, gender, age, and education level.

Health disparities on the Respiratory Illness Data Dashboard can be observed when looking at different demographic factors such as age, sex, and race/ethnicity. An explanation of these factors and some of the health disparities observed for the respiratory illness displayed on this dashboard are described below.

To protect individual privacy, some very small counts and rates in a given category are not shared. Counts for some age categories may be small, especially in small counties. Therefore, we do not report counts if there are less than 10 in a category. We take additional measures to prevent recalculating these small counts by reporting data in related columns and rows. This data is not included in dashboard tables and downloadable files. Our policy for reporting small numbers (PDF) balances privacy protection with the publics need for data.

Due to the current lack of Small Area Estimates from Office of Financial Management (OFM), the population data used to calculate rates in this dashboard come from the Population Interim Estimates (PIE) developed by Public Health-Seattle and King County (PHSKC). Because we have applied PIE to historic data, some COVID-19 rates will be different from what we published previously.

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Respiratory Illness Data Dashboard | Washington State Department of Health - Washington State Department of Health

December 12, 2023

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Hospitalizations and deaths due to COVID-19 in patients with autoimmune rheumatic diseases declined significantly during the most recent 2 years of the pandemic, partly thanks to vaccination among vulnerable populations, according to data.

Although by the end of 2022 COVID-19 still remained prevalent, the severity of the disease in the general population had considerably decreased compared to earlier phases of the pandemic, Charalampos Papagoras, MD, PhD, of the University Hospital of Alexandroupolis, in Greece, and colleagues wrote in Clinical Rheumatology. This is due to infection-acquired, vaccine-induced and hybrid immunity against SARS-CoV-2, as well as the latest dominance of the omicron virus strain, which is thought to cause milder disease.

Preliminary evidence suggests that COVID-19 runs a milder course during the later phases of the pandemic among patients with SAIRDs, as well, they added. However, it is not clear whether this is due to previously acquired anti-SARS-CoV-2 immunity, to infection by the Omicron strain or both.

To examine whether the availability of COVID-19 vaccines and the emergence of omicron as the dominant strain significantly impacted hospitalizations and mortality in patients with systemic autoimmune rheumatic diseases (SAIRDs), Papagoras and colleagues analyzed data from the Greek Rheumatology Society COVID-19 registry. Patients were included in the analysis if they had a confirmed SAIRD diagnosis and had contracted COVID-19 at some point. Patients were excluded from the analysis if they had been diagnosed with non-inflammatory musculoskeletal diseases like osteoarthritis.

Severe disease was defined hospitalization or death. Patients were evaluated in groups according to vaccination status vaccinated vs. unvaccinated. Finally, the researchers evaluated the impact of the pandemic through four time periods defined by the dominant strain of disease in Greece. These were the wild-type variant, which lasted until the second week of 2021; the alpha variant, which was present until the 26th week of 2021; the delta variant, which was dominant until week 50 of 2021; and the omicron variant, which lasted until June 30, 2022.

During the study period from August 2020 to June 30, 2022, 456 cases of COVID-19 were reported among the cohort. Among unvaccinated individuals in this group, the proportion of patients requiring hospitalization was 24.5% and the proportion of those who died was 4%. Among vaccinated patients, meanwhile, 12.5% were hospitalized and 0.8% died (both P < .001).

According to the researchers, 24.7% of included patients were hospitalized and 2.7% died due to COVID-19 during the wild-type variant period, compared with 31.3% and 4% during the alpha period, 25.9% and 7% during the delta wave, and 8.1% and 0% during the omicron period (P = .001).

Factors associated with hospitalization were infection with variants other than omicron, as well as previous documented exposure to rituximab (Rituxan, Genentech) and not being vaccinated. Factors linked to death included infection during the alpha or delta periods, existing pulmonary disease and older age. Vaccination against COVID-19 was protective, according to the researchers.

Since the outset of the pandemic, the clinical features of COVID-19 in patients with SAIRDs have changed, with fewer hospitalizations and deaths during the latest phase, similar to the general population, Papagoras and colleagues wrote. This overview of the Greek COVID-19 registry shows that the major determinants for this shift was the acquisition of large-scale anti-SARS-CoV-2 immunity, particularly through vaccination, as well as the dominance of the omicron virus strain, which appears to cause a less severe disease.

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COVID-19 hospitalizations, deaths in patients with SAIRDs declined during omicron wave - Healio

FLORIDA, USA The U.S. Centers for Disease Control is reporting an increase in the COVID-19 virus both nationwide and in the state of Florida. While Florida has only recently resumed gathering wastewater surveillance data to track the spread of the virus by county, some of the currently available figures suggest the Sunshine State may be heading for levels of the virus last reached in August.

While not all Florida counties have submitted recent wastewater data, making the state's overall figures inconclusive for now, nearly all of the counties with data from November and December showed an upswing in virus activity.

Alachua, Miami-Dade, Palm Beach and Seminole counties all showed an increase in the virus starting in November and continuing to rise after Thanksgiving weekend, according to wastewater data submitted to Biobot.

In the nation at large, the highest levels of virus activity and the steepest jumps in hospital admissions from the virus are happening in states further north, including West Virginia, Ohio, Wisconsin, South Dakota and Montana.

Of all the COVID-19 virus variants detected in wastewater sites, the predominant strain continues to be EG.5, which has dominated the strains for at least four months. A pediatric infectious disease specialist interviewed by the magazine "Health" said the patients she saw who had tested positive for the EG. 5 variant had symptoms similar to past Omicron variants. She also said some of her patients initially thought they had allergies due to the nature of the symptoms. These included:

The latest COVID-19 booster vaccine has been deemed effective in reducing symptoms and helping protect against the latest variants of the virus, though CDC data suggests only 17 percent of the population has gotten their COVID-19 booster shots.

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Florida sees 'COVID bump' going into the holiday season - WTSP.com

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Ohio COVID-19 cases are up. Will they spike more? What doctors say - The Columbus Dispatch

House lawmakers investigating COVID pandemic demand testimony of top Cuomo aide on nursing home deaths

by Alex Weidner

Melissa DeRosa, a top aide to former Governor Andrew Cuomo. (FILE)

Albany, NY (WRGB)

Former Andrew Cuomo top aide Melissa DeRosa is finding herself in hot water with a congressional subcommittee. In a letter to DeRosa, Ohio Republican Rep. Brad Wenstrup says DeRosa's memoir contradicts her own statements on her involvement with a New York State mandate that put COVID-positive patients back into nursing homes at the height of the pandemic.

The Select Subcommittee on the Coronavirus Pandemic requested DeRosa's testimony this month. The panel is looking into the March 25, 2020 order from then-Governor Cuomo's Department of Health, and allegations of a cover up of the thousands of deaths blamed on it.

The subcommittee points to DeRosa's book, "What's Left Unsaid"-- which includes an entire chapter on the nursing home controversy. Part of the letter reads:

DeRosa would have the panel believe she doesn't have possession of any notes or journals used in writing that part of the book, a claim backed up by her attorney Greg Morvillo.

In calling again on DeRosa to testify, the subcommittee suggests she was involved in the administration's decision on nursing home residents, and the subsequent cover up. Excerpted from the letter:

"The Committees position is factually wrong," adds Morvillo. "There is nothing in Ms. DeRosas memoir that says this in fact, the Committee members claim to have read Ms. DeRosas book, but anyone who has actually read the book would know that this comment is clearly and factually inaccurate."

Rich Azzopardi, a spokesman for Andrew Cuomo, tells CBS 6, "Counsel is responding to the letter, but lets be clear the data they seek - which has already been reviewed twice by the DOJ, as well as the State Assembly and the AG, all of which found no there, there - is with the state. Once again, it's unfortunate that some DC politicians are seeking to transparently weaponize people's pain to advance a political agenda."

DeRosa has until January 19, 2024 to testify before the subcommittee, under penalty of criminal prosecution.

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House lawmakers investigating COVID pandemic demand testimony of top Cuomo aide on nursing home deaths - WRGB

Although COVID-19 hospital admissions in suburban Cook County continue to be low, they have almost doubled since the beginning of November; and emergency room visits associated with COVID have been trending upward since early October.

That is why Cook County Department of Public Health is urging residents to take precautions when gathering with their families and friends for the holidays.

We want to encourage Cook County residents to remain vigilant during this holiday season, said Dr. LaMar Hasbrouck, chief operating officer of Cook County Department of Public Health.

The single most important way to protect yourself and your families from COVID, flu, and RSV is to stay up to date with recommended vaccinations. Its science at work. Its safe. Its proven. And it works.

According toCook County Department of Public Healthdata for the week ending Nov. 25, there are seven COVID-19 hospital admissions for every 100,000 residents of suburban Cook County. Most admissions are among those age 65 and older.

The presence of SARS-CoV-2 in wastewater is an early indicator of COVID-19 activity. Wastewater viral concentrations are currently at the highest levels seen so far this year, indicating ongoing community transmission.

As of Dec. 1, 10% of Cook County residents have received the 2023-2024 updated annual COVID-19 vaccine.Everyone 6 months and older should get updated COVID-19 and flu vaccines each year. Immunization for RSV is recommended for infants; and the RSV vaccine is recommended for pregnant women and adults 60 years and older. Adults can receive the RSV, COVID-19, and flu vaccines at the same time.

In addition to staying up to date on all recommended vaccinations, Cook County Department of Public Health recommends residents take the following precautions when gathering during the holidays:

Find more information and resources about vaccinations atBoostUpCookCounty.com.

Hanania also writes about Middle East issues for the Arab News, and The Arab Daily Newscriticizing government policies in the Israeli-Palestinian conflict.

Hanania was named "Best Ethnic American Columnist" by the New America Media in November 2007, and is the 2009 recipient of the SPJ National Sigma Delta Chi Award for column writing.

Email Ray Hanania at rghanania@gmail.com.

Follow RayHanania on Gettr.com, the uncensored Twitter Ray Hanania on Gettr, the new Twitter

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Cook County Department of Public Health Urges Suburban Cook County to Take COVID Precautions During the ... - Suburban Chicagoland

LONDON, Dec 6 (Reuters) - British former prime minister Boris Johnson gave his most explicit apology for his handling of the coronavirus crisis on Wednesday, saying his government had been too complacent and "vastly underestimated" the risks posed by the virus.

In an appearance before an official inquiry into the UK's handling of the pandemic, Johnson said he took responsibility for all decisions made and he understood the public's anger after the inquiry heard of government incompetence, backstabbing and misogyny as it battled the biggest health crisis in decades.

Johnson said COVID-19 had first appeared as a "cloud on the horizon" and not the "typhoon" that went on to kill more than 230,000 people in Britain and infect many millions more.

Initially, Johnson said he did not believe the forecasts of fatalities because previous health scares, such as the swine flu pandemic and mad cow disease, ended up with much lower death tolls than first expected.

But Johnson admitted only reading the minutes of the government's key scientific advisory group on a couple of occasions despite the conclusions leading to the biggest restrictions on freedoms in Britain since World War Two.

"Can I say that I understand the feelings of the victims and their families, and I am deeply sorry for the pain and the loss and the suffering," he said at the start of two days of testimony.

Johnson, prime minister for three years between 2019 and 2022, resigned in disgrace after a series of scandals including reports that he, and other officials, had been present at alcohol-fuelled gatherings in Downing Street during 2020 and 2021 when most people in Britain were forced to stay at home.

The inquiry has already heard damaging testimony about his reluctance to lock down, and how he was confused by the science of the virus, which almost killed him.

Johnson was said to have asked at one point if blowing a hair-dryer up his nose could kill COVID and suggested he should be injected with it on live TV. He admitted during his evidence being "bewildered" by data showing the health service could be overwhelmed.

[1/9]Former British Prime Minister Boris Johnson gives evidence at the COVID-19 Inquiry, in London, Britain, December 6, 2023 in this screen grab obtained from a handout video. UK Covid-19 Inquiry/Handout via REUTERS Acquire Licensing Rights

The inquiry gave Johnson a platform to map out his own history of the crisis. Where sometimes he was combative, on another occasion he fought back tears when he described 2020 as a "tragic year".

Britain had been an outlier in Europe at the start of the pandemic, when large public events remained open despite nightly news programmes showing chaotic scenes in Italian hospitals.

The former prime minister faced repeated questions about whether he waited too long to impose a lockdown at the start of 2020 and if that resulted in Britain ending up with one of the world's highest death tolls from the pandemic.

Denying he was indecisive, Johnson said there were constant, conflicting arguments between ministers and officials about how to respond and senior ministers were more reluctant than he was to impose restrictions on the public's movements.

Johnson arrived at the inquiry more than three hours before the hearing began, avoiding the families of some of those who died from COVID-19, who had wanted to confront him.

The start of the session was also disrupted by protesters.

Aamer Anwar, the solicitor representing some bereaved COVID families, said Johnson oversaw "a deadly culture of impunity, incompetence" and treated people like "toxic waste".

The inquiry heard evidence from former advisers that Johnson wanted to let the virus spread rather than order another lockdown and he once replied "let the bodies pile high".

Johnson said abusive messages between officials were sometimes "creatively useful". But he admitted his team would have worked better if it had more women.

In one messages shown to the inquiry, Cummings, who was then Johnson's most senior official, complained in profanity-laden messages that he was "dodging stilettos" from a female colleague and wanted to "handcuff her and escort her" from Downing Street.

Reporting by Andrew MacAskill, Sarah Young and Michael Holden; Editing by Kate Holton, Angus MacSwan, Christina Fincher, Alexandra Hudson

Our Standards: The Thomson Reuters Trust Principles.

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UK COVID inquiry: Boris Johnson says he underestimated threat from virus - Reuters UK