Category: Covid-19

Two new studies highlight the impact that the COVID-19 pandemic has had on antibiotic use and resistance.

In one study, data gathered by researchers from the World Health Organization (WHO) confirms what previous research has shownglobally high rates of antibiotic use in COVID-19 patients despite low rates of suspected bacterial infections. In the other, a team led by researchers from the National Institutes of Health (NIH) found that rates of hospital-acquired, multidrug-resistant infections at US hospitals remain well above pre-pandemic levels.

Both studies are being presented at the upcoming European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Global Congress in Barcelona, Spain.

The WHO data, collected through the WHO Global Clinical Platform, shows that, among 592,898 COVID-19 patients hospitalized in 65 countries from January 2020 through March 2023, antibiotic use ranged from 83% in the WHO Eastern Mediterranean Region to 32.8% in the Western Pacific Region. Overall, three of four COVID-19 patients received antibiotics, despite the fact that antibiotics provide no benefit for the viral illness.

The highest rate of antibiotic use was seen among patients with severe or critical COVID-19, 81% of whom received antibiotics. But even in patients with mild or moderate COVID, antibiotics were commonly used, with rates as high 79% in the African Region. Empiric treatment was common, ranging from 55% in patients with mild/moderate COVID-19 to 69% in severe critical cases.

While antibiotic prescribing rates for COVID-19 declined over time in Europe and the Americas from the beginning of the pandemic through 2022, they increased in Africa.

Although frequent use of antibiotics in the early months of the pandemicwhen hospitals were overwhelmed and few treatment options were availablehas been well documented, the continued use of antibiotics for COVID well into the pandemic is concerning. The WHO says they're concerned that this extensive overuse of antibiotics is contributing to the "silent spread" of antimicrobial resistance (AMR).

In another concerning finding, the data also show that antibiotics with an increased risk of promoting resistanceknown as "Watch" antibiotics under the WHO's AWaRE (Access, Watch, and Reserve) classification systemwere frequently prescribed for COVID-19 patients in the Eastern Mediterranean Region (93.8%), the Region of the Americas (90.8%), and the African Region (91.1%).

But, as has been found in previous studies, there is little reason to prescribe antibiotics for patients with COVID-19. Suspected bacterial co-infectionswhich might justify use of antibiotics in some caseswere reported in only a fraction (8%) of COVID-19 patients. Higher rates of bacterial co-infections were reported in the Region of the Americas (14.1%) and the Eastern Mediterranean Region (8.8%).

Unsurprisingly, antibiotics did not improve clinical outcomes for COVID-19 patients. In fact, an analysis of patients without suspected or confirmed bacterial infections found that patients with mild/moderate COVID-19 who received empiric antibiotic therapy had an 80% increased mortality risk (adjusted hazard ratio [aHR], 1.80; 95% confidence interval [CI], 1.36 to 2.38) compared with those didn't receive antibiotics.

Patients with severe/critical COVID-19 who received antibiotics had a 16% increased risk of death (aHR, 1.16; 95% CI, 1.08 to 2.84).

"When a patient requires antibiotics, the benefits often outweigh the risks associated with side effects or antibiotic resistance. However, when they are unnecessary, they offer no benefit while posing risks, and their use contributes to the emergence and spread of antimicrobial resistance," Silvia Bertagnolio, MD, WHO unit head for surveillance, evidence, and laboratory strengthening in the Division for AMR, said in a WHOpress release.

"These data call for improvements in the rational use of antibiotics to minimize unnecessary negative consequences for patients and populations," she added.

Meanwhile, data collected from 120 US hospitals from January 2018 through December 2022 illustrate how AMR surged during the pandemic, driven largely by dramatic increases in hospital-acquired infections.

In the study, researchers examined all adult hospitalizations over the period for culture-confirmed infection by six pathogens: methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus(VRE), extended-spectrum cephalosporin-resistant Enterobacterales (ECR), carbapenem-resistant Enterobacterales (CRE), Acinetobacter baumannii (CRAB), and Pseudomonas aeruginosa (CR-PA). Hospital-acquired infections were defined as those that occurred after 3 days of hospitalization.

These data call for improvements in the rational use of antibiotics to minimize unnecessary negative consequences for patients and populations.

The researchers wanted to provide an update to a previous report by the Centers for Disease Control and Prevention (CDC). The report, published in 2022, showed alarming increases in the six pathogens at US hospitals during first year of the pandemic, resulting in a 15% overall increase in drug-resistant infections and deaths from 2019 through 2020.

The NIH-led study found the overall prevalence of AMR infections increased by 6.3% during the pandemic, driven mainly by hospital-acquired infections, which rose 32.4%, compared with a 1.4% increase in community-acquired infections. Among the hospital-acquired infections, the largest increases were seen for CRAB (a 160.0% increase), CRE (63.6%), CR-PA (54.5%), and ECR (50%). Conversely, community-acquired MRSA infections fell 10% during the pandemic, a result the researchers believe is linked to reduced social interactions.

As with the CDC report, the researchers believe the surge in multidrug-resistant, hospital-acquired infections is likely the result of a combination of pandemic-related factors.

"It is likely that surges in severely ill COVID-19 patients during the pandemic corresponded with significant surges in antibiotic use and challenges following infection and prevention control protocols in strained hospitals," lead author Christina Yek, MBBCh, of the National Institute of Allergy and Infectious Diseases, said in an ESCMIDpress release. "In addition, hospitals may have experienced shortages of personal protective equipment, while treating sicker patients who were more likely to require the use of medical devices like ventilators, which would have added to the spread of antimicrobial-resistant infections."

Yek and her colleagues also found that the hospitals that saw the largest surges in severely ill COVID-19 patients had the largest increases in hospital-acquired AMR infections.

And while the overall prevalence of AMR infections in US hospitals returned to pre-pandemic levels (a 0.2% increase) by the end of 2022, hospital-acquired AMR infections remained 13% above baseline, largely because of continued increases in carbapenem-resistant gram-negative pathogens. From March to December 2022, CRE, CRAB, and CR-PA infections were 81%, 43%, and 38% above pre-pandemic levels.

Yek said the persistence of these infections is concerning.

"More action is needed to protect people, especially from difficult-to-treat hospital-acquired gram-negative infections that remain concerningly high," she said.

Go here to read the rest:

Global, US data show high antibiotic use, rise in resistant infections during COVID - University of Minnesota Twin Cities

Health

Share on Facebook Share on Twitter Share by Email

Posted: April 18, 2024

The World Health Organization (WHO) and around 500 experts have agreed for the first time what it means for a disease to spread through the air, in a bid to avoid the confusion early in the COVID-19 pandemic that some scientists have said cost lives.

The Geneva-based U.N. health agency released a technical document on the topic on Thursday. It said it was the first step towardworking out how to better prevent this kind of transmission, both for existing diseases like measles and for future pandemic threats.

The document concludes that the descriptor "through the air" can be used for infectious diseases where the main type of transmission involves the pathogen travelling through the air or being suspended in the air, in line with other terms such as "waterborne" diseases, which are understood across disciplines and by the public.

Almost 500 experts contributed to the definition, including physicists, public health professionals and engineers, many of whom disagreed bitterly over the topic in the past.

Agencies have historically required high levels of proof before calling diseases airborne, which required very stringent containment measures; the new definition says the risk of exposure and severity of disease should also be considered.

WATCH | Airborne transmission and COVID-19:

Show more

Past disagreements also centred on whether infectious particles were "droplets" or "aerosols" based on size, which the new definition moves away from.

During the early days of COVID in 2020, around 200 aerosol scientists publicly complained that the WHO had failed to warn people of the risk that the virus could spread through the air. This led to an overemphasis on measures like handwashing to stop the virus, rather than focusing on ventilation, they said.

By July 2020, the agency said there was "evidence emerging" of airborne spread, but its then chief scientist Soumya Swaminathan,who began the process to get a definition, later said the WHO should have been more forceful "much earlier."

Her successor, Jeremy Farrar, said in an interview that the new definition was about more than COVID, but he added that at the beginning of the pandemic there was a lack of evidence available and experts including the WHO acted in "good faith." At that time, he was head of the Wellcome Trust charity and advised the British government on the pandemic.

Farrar said getting the definition agreed upon among experts from all disciplines would allow discussions to begin about issues such as ventilation in many different settings, from hospitals to schools.

He compared it to the realization that blood-borne viruses like HIV or hepatitis B could be spread by medics not wearing gloves during procedures.

"When I started out, medical students, nurses, doctors, none of us wore gloves to take blood," he told Reuters. "Now it is unthinkable that you wouldn'twear gloves. But that came because everyone agreed on what the issue was, they agreed on the terminology.[The change in practice] came later."

Read more:

WHO experts now agree diseases like COVID spread through the air - CBC News

An initial zero draft that circulated more than a year ago now appears to have been diluted, or as the Lancet medical journal notes, filled with platitudes, caveats and the term where appropriate.

In early 2023, the zero draft contained details on building an equitable global health security ecosystem. It included recommendations on supply chain resilience for products needed to ensure health security.

But now, with the World Health Assembly meeting just weeks away, differences between the rich Western countries and the developing world seem wider than ever. When the latest round of negotiations ended inconclusively on March 28, the Fox News channel in the United States went on the attack with a story highlighting critics who say the Biden administration was selling out US sovereignty.

The foundation insists the agreement should be rejected in its current draft form, and that even an improved draft would need to be submitted to the US Senate for advice and consent.

In the US Congress, Brad Wenstrup, the Republican chair of the US House Select Subcommittee on the Coronavirus Pandemic, insisted the treaty must not violate international sovereignty or infringe upon the rights of the American people or the intellectual property of the US.

Voicing the concerns of the global science community, a Lancet editorial retorted that such approaches were shameful, unjust and inequitable, saying that there is a need for high-income countries and private companies to behave fairly, [and] that they do not stockpile millions of doses of vaccines or refuse to share life-saving knowledge and products.

The editorial complained that, under the current draft treaty, the WHO would only have access to 20 per cent of the pandemic-related products for distribution based on public health risks and needs, leaving 80 per cent of medicines and vaccines prey to the international scramble that in Covid-19 saw vital health technologies sold to the highest bidder.

Ensuring equitable access is not an act of kindness or charity, it insisted: It is an act of science, an act of security and an act of self-interest Ultimately it is the politicians of G7 countries who must put aside vested industry interests and finally understand that in a pandemic it is not possible to protect only your own citizens.

It is of course possible that, by some miracle of pragmatism, a meaningful pandemic treaty will emerge from next months World Health Assembly, just as it is possible for China to open its doors to further investigations into the origins of Covid-19, or for the US government to face down the pharmaceutical giants keeping a firm grip on intellectual property rights.

The realist in me says we are likely to emerge with few meaningful protections. As Horton noted a year ago: Delivering a global agreement on pandemic preparedness and response would be challenging even in the best of circumstances. And todays fractured and hostile world does not present the best of circumstances.

Failure to secure an agreement would be a tragedy for which we would pay a terrible price, perhaps dangerously soon.

David Dodwell is CEO of the trade policy and international relations consultancy Strategic Access, focused on developments and challenges facing the Asia-Pacific over the past four decades

Original post:

How nationalism threatens a repeat of Covid-19 tragedies in next pandemic - South China Morning Post

jacksonville.com wants to ensure the best experience for all of our readers, so we built our site to take advantage of the latest technology, making it faster and easier to use.

Unfortunately, your browser is not supported. Please download one of these browsers for the best experience on jacksonville.com

Originally posted here:

Jacksonville attorney is sentenced to prison in COVID-19 relief fraud - The Florida Times-Union

This brief is part of a larger research project, Cities as Home, carried out by IOM Iraq, the Returns Working Group, and Social Inquiry, that explores both drivers and deterrents of integration across 14 urban locations that still host the largest share of IDPs in the country. The outputs of this project also include an analysis report on determinants of integration for IDPs and host community members, factsheets for each location, and four detailed case studies.

More:

Cities as Home: Describing the Regulatory Landscape Around COVID-19 and its Implications for the Local Integration ... - ReliefWeb

Thinking about getting a spring-time booster shot?A new studycoming out of York University's Centre for Disease Modelling in the Faculty of Science shows that immunity after a COVID-19 booster lasts much longer than the primary series alone. These findings are among other, sometimes "unintuitive," revelations of how factors like age, sex and comorbidities do and don't affect immune response.

The study's authorsYork Post Doctoral researchers Chapin Korosec and David Dick, Applied Mathematics Professor Iain Moyles and Professor James Watmough with the University of New Brunswickused health data submitted to the Covid Immunity Task-Force project for more than 150 individuals who received either Pfizer-BioNTechor Moderna COVID-19 vaccines to look at how immunity holds up over time.

Our approach as mathematicians is to create mathematical models of the immune system, and then calibrate those models to health care data in order to advance our understanding of the human immune system. It was really interesting to see the SARS-CoV-2 booster dose have such a huge increase in protective longevity capacity as compared to the primary series of two doses."

Chapin Korosec, study's lead author

Published today in the journalScientific Reports, the study used Canadian vaccine data collected from individuals living in long-term care, as well as frontline health-care workers working in long-term care and hospitals.

Looking at the group as a whole, the median length for the antibody half-life immune response was 63 days for the primary series, and increased to 115 days for those who went on to receive their boosters, a statistically significant finding, says Korosec.

It is well-established that age can affect how adept the body is at priming an immune response after vaccines, so much so that advanced age is considered a comorbidity itself, says Korosec.

"Chronological age is your time since birth. But you also have an immunological age, which is correlated to your chronological age, and is related to how your body loses its ability to prime against invading pathogens and produce antibodies as time marches on," explains Korosec. "What's convoluted is that as we age chronologically, the probability that we accrue diseases that can affect the immune system in unintuitive ways also increases."

Looking into this aspect, the researchers found that older adults did have a less long-lasting immune response, but once they controlled for other comorbidities such as hypertension, lung disease and cancer, age no longer had as significant of an influence on the immune response.

Other interesting findings include a small, but statistically significant immune response for males versus females, and people with asthma having a longer lasting immune response more durable, in fact, than those with hybrid immunity from vaccines and contracting COVID-19.

"We found that some outcomes were surprising and worth further study, but of course we're not advocating any particular comorbidity is beneficial," says Dick. "We don't have any information from this study on how asthma would affect the severity of the COVID-19 illness, for example."

Outside of the strict findings, the researchers also say the study points to the importance of interdisciplinary research and are excited about the possibilities for collaboration, with plans to open York's medical school in 2028.

"While we're all from math and stats departments, the data comes from clinicians who went through medical school and are now professors studying immunology, and I think this study shows how people with different skill sets can come together and do really interesting science," says Korosec.

Adds Moyles: "We have a really top applied math program at York, and now the university has announced a medical school. Imagine these clinicians were at York and we had access to the data on the ground floor. This would cut the research timeline by years and has huge potential for future interdisciplinary research at the university."

Source:

Journal reference:

Korosec, C. S., et al. (2024). SARS-CoV-2 booster vaccine dose significantly extends humoral immune response half-life beyond the primary series.Scientific Reports. doi.org/10.1038/s41598-024-58811-3

More here:

Boosted immunity: Study reveals longevity of COVID-19 booster shots - News-Medical.Net

Milton, along with fellow experts from around the globe, drafted a consultation report outlining types of respiratory virus transmission and airborne infections the main focus of Milton's work for the past 25 years. The report sought to establish wording that could be easily used and understood by all professional groups.

The report corrects a number of misconceptions and misunderstandings that were major problems earlier in the COVID-19 pandemic. said Milton. It is important to have clear terminology and a shared understanding as a basis for developing effective policy to prevent infection and control pandemics.

The report proposes airborne transmission/inhalation as the best term for infectious respiratory particles emitted into the air and breathed in. This transmission can cause infection and can occur when the particles travel both short and long distances from the person with the infection.

When infectious respiratory particles follow a semi-ballistic trajectory over a short distance through the air and land directly onto the mouth, nose or eyes of another individual, the report proposes using the term direct deposition.

The report states clearly that the risk of airborne/inhalation transmission is greatest close to an infected person, Milton said.

The new report offers clarification that infectious particles floating in the air can be various sizes. Because the terms aerosol and droplet were misunderstood or used differently in different scientific disciplines, these terms were avoided in this report.

Though the report helps clarify terminology for important modes of respiratory infection transmission, Milton notes that there is still a great deal of work needed to reach scientific consensus on the relative importance of each mode for specific infectious agents.

These two modes are very different. They require very different controls to protect healthcare workers and other high-risk people, Milton said. How this report is translated into infection prevention and control policy will be critical that work lies ahead. Acknowledging that airborne/inhalation and direct deposition transmission are very different, as described in the body of the report, could be a first step toward new and more effective policies.

This report, 20 years after the release of pivotal research in the New England Journal of Medicine outlining the airborne transmission of SARS-CoV-1 and Miltons NEJM Perspective on airborne transmission, is one step WHO is taking to standardize scientific terminology. The organization plans to research this topic further through the collaboration of scientists in other disciplines and explore broader implications the updated terminology may have on health care.

I hope that this report will help move that process toward a stronger foundation in the science of airborne infection, Milton said.

-By Sumaya Abdel-Motagaly 26

Originally posted here:

SPH professor coauthors new WHO report to combat COVID-19 misinformation - University of Maryland | School of Public Health

Specialty

Please choose I'm not a medical professional. Allergy and Immunology Anatomy Anesthesiology Cardiac/Thoracic/Vascular Surgery Cardiology Critical Care Dentistry Dermatology Diabetes and Endocrinology Emergency Medicine Epidemiology and Public Health Family Medicine Forensic Medicine Gastroenterology General Practice Genetics Geriatrics Health Policy Hematology HIV/AIDS Hospital-based Medicine I'm not a medical professional. Infectious Disease Integrative/Complementary Medicine Internal Medicine Internal Medicine-Pediatrics Medical Education and Simulation Medical Physics Medical Student Nephrology Neurological Surgery Neurology Nuclear Medicine Nutrition Obstetrics and Gynecology Occupational Health Oncology Ophthalmology Optometry Oral Medicine Orthopaedics Osteopathic Medicine Otolaryngology Pain Management Palliative Care Pathology Pediatrics Pediatric Surgery Physical Medicine and Rehabilitation Plastic Surgery Podiatry Preventive Medicine Psychiatry Psychology Pulmonology Radiation Oncology Radiology Rheumatology Substance Use and Addiction Surgery Therapeutics Trauma Urology Miscellaneous

Read more from the original source:

Free-Floating Thrombus of the Aorta: A Rare Complication of COVID-19-Induced Hypercoagulability - Cureus

The North Carolina Court of Appeals ruled Tuesday that Gov. Roy Coopers closure of certain bars, but not restaurants, in the early months of the pandemic was irrational and arbitrary, not based on data and science.

Our careful review of the Record does not reveal the existence of any scientific evidence demonstrating Plaintiffs bars, as opposed to the bars located in other establishments serving alcohol, posed a heightened risk at the time Executive Order No. 141 was issued, wrote Judge April C. Wood, a Republican. Overall, the articles and data submitted by Defendant entirely fail to address any differences in the risk of spread of COVID-19 between the bars he allowed to reopen and Plaintiffs bars which remained closed.

Cooper issued an executive order early in the pandemic, on March 17, 2020, closing all bars in North Carolina. On May 20, 2020, he issued another executive order, allowing some but not all bars to reopen with specific safety precautions. Coopers attorneys said hed relied on science and data to determine which types of bars should be allowed to open and which should remain closed, using research showing that bars presented a higher risk of COVID-19 transmission.

But Woods 39-page opinion, joined by Republican colleagues Judges Donna Stroud and Jefferson Griffin, who is also running for the state Supreme Court, said that Cooper did not submit any evidence that showed why members of the North Carolina Bar and Tavern Association the plaintiff in the lawsuit would have been unable to comply with his executive order, when he allowed other types of bars to reopen under certain restrictions.

It is illogical and arbitrary to attempt to achieve Defendants stated health outcomes by applying different reopening standards to similarly situated businesses that could have complied with those standards, Wood wrote. In other words, if restaurants serving alcohol could operate at fifty percent capacity and keep groups six feet apart with both food and alcohol at the customers tables, Defendant has failed to present any forecast of evidence of any reason bars would not be able to do the same with alcohol service.

Cooper wrote in the executive order that bars presented a greater risk to spreading COVID-19, due to factors such as people traditionally interacting in that space in a way that would spread COVID-19 . . . or a business model that involves customers or attendees remaining in a confined indoor space over a sustained period.

But Wood wrotein her ruling that Cooper didnt have sufficient science and data at the time of the executive order to justify closing some bars and not others.

Most of the information is news articles, at best anecdotal reports of various incidents in different places around the world, Wood wrote. None of the information addresses any differences in risk of COVID-19 transmission between Plaintiffs bars and the other types of bars allowed to reopen.

Wood wrote that news reports cited by Coopers attorneys were not the same as scientific studies.

Research such as these news articles could be conducted by private citizens utilizing Internet search engines, Wood wrote. In fact, many of the documents in the Record were gathered from Internet searches as evidenced by the tags and links at the bottom of the printed pages.

The panel sent the case back down to the trial court for further proceedings.

Wood and her colleagues did not agree with every argument the Bar and Tavern Association made. The court ruled that the associations members were not entitled to financial compensation under the Emergency Management Act because Cooper did not physically take their land or property; he merely prohibited them from using their land for the purpose of conducting their business. Wood wrote that what Cooper did was within the bounds of state law, and not within the parts of the statute the legislature determined would give someone a right to compensation.

Clearly, the General Assembly considered which governmental actions would trigger a statutory right to compensation and employed language which encompassed certain specific actions while excluding others, wrote Judge April C. Wood, a Republican. Ordering mandatory business closures is not one of those actions which triggers a statutory right of compensation under the statute as it is currently written.

Click here to read the courts ruling in N.C. Bar and Tavern Association v. Cooper.

Continue reading here:

Appeals Court: Gov. Roy Cooper erred in COVID-19 bar closures - NC Newsline

In a recent study published in the journal Science Translational Medicine, researchers investigated the impact of aging on immune response, viral dynamics, and nasal microbiome in 1031 hospitalized coronavirus disease 2019 (COVID-19) patients, using advanced profiling techniques to understand age-related differences in disease severity and immune function.

Study: Host-microbe multiomic profiling reveals age-dependent immune dysregulation associated with COVID-19 immunopathology. Image Credit:Corona Borealis Studio/ Shutterstock

Age is a significant risk factor for severe COVID-19 outcomes, with older adults facing drastically higher risks of complications and mortality than younger individuals. Despite high vaccination rates, older adults are still profoundly vulnerable. Aging correlates with elevated levels of inflammatory cytokines, like interleukin-6 (IL-6), which are critical markers of COVID-19 severity, hinting at a link between aging and disease pathophysiology. Studies show that aging dampens both innate and adaptive immune responses, including reduced type I interferon (IFN) production. Additionally, older adults show enhanced inflammatory responses and impaired immune signaling when infected with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Further research is needed to fully understand the complex interactions between aging, immune response variations, and COVID-19 severity to improve treatment strategies and outcomes for older populations.

The present study utilized data from 1,031 participants enrolled in the IMmunoPhenotyping Assessment in a COVID-19 Cohort (IMPACC) observational cohort, which involved 20 hospitals across 15 medical centers in the United States from May 5, 2020, to March 19, 2021. It involved hospitalized individuals with reverse transcription polymerase chain reaction (rt-PCR) confirmed SARS-CoV-2 infections, displaying typical COVID-19 symptoms. Blood and respiratory tract samples were collected within 72 hours of hospitalization, following a standardized protocol across participating institutions. Ethical approval was granted under the public health surveillance exception, with participant consent for follow-up involvement and data usage.

Statistical analysis was performed using R software. Initial assessments were done within 72 hours of hospital admission, followed by longitudinal evaluations at subsequent visits. Data analysis applied various statistical methods depending on the data type and required adjustments for factors like age, sex, and baseline disease severity. For longitudinal studies, age groups were divided into quintiles and analyzed for changes in viral abundance and immune response, employing linear and generalized additive models to account for the observed non-linear patterns. All p-values were adjusted using the Benjamini-Hochberg method, considering results statistically significant at p < 0.05.

The study involved analyzing blood and nasal swab specimens from 1,031 vaccine-nave adults hospitalized with COVID-19. These participants were part of the IMPACC cohort, sourced from 20 hospitals across the United States. They were categorized into five age quintiles, ranging from 18 to 96 years, with each group comprising between 187 and 223 individuals. Samples were collected at the time of hospital admission and during up to five follow-up visits. The distribution of ages showed that older individuals were often more severely affected by the disease, evident in both the initial severity of symptoms and the outcomes, including mortality.

At the initial hospital visit, typically within 72 hours of admission, a range of diagnostic assays was conducted. These included transcriptional profiling of peripheral blood mononuclear cells (PBMCs) and nasal swabs, serum inflammatory protein profiling, whole blood mass cytometry (CyTOF), nasal metatranscriptomics, and SARS-CoV-2 antibody (Ab) assays. A significant finding from these initial tests was that older adults displayed higher viral loads and experienced delayed viral clearance compared to younger patients. Moreover, age-related differences in immune cell populations were noted, with older adults showing higher proportions of various monocyte subtypes and activated T cells but lower levels of nave T and B cells.

The study's longitudinal analysis revealed that these differences persisted over time, affecting viral load dynamics, antibody titers, and immune response. Specifically, the eldest participants not only retained high levels of the virus longer but also showed more significant fluctuations in antibody levels over time. Additionally, immune cell analysis by CyTOF highlighted that with advancing age, certain immune cell types, including different monocyte classes and differentiated natural killer cells, increased, suggesting shifts in immune system composition and function with age.

Changes in cytokine and chemokine levels measured in the participants' serum further underscored the impact of aging on the immune response. Older individuals showed elevated levels of inflammatory markers at hospital admission, which were linked to more severe disease outcomes.

Moreover, the analysis extended to the nasal microbiome and upper respiratory gene expression, revealing age-associated changes in the microbial composition and host gene activity. Changes in Toll-like receptor signaling and other immune pathways were evident, suggesting that older adults experience different immune modulations, possibly influencing their susceptibility to severe outcomes.

Read this article:

Aging affects immune response and virus dynamics in COVID-19 patients, study finds - News-Medical.Net