New clinical trial to test whether structured exercise benefits ‘long Covid’ patients

Researchers at the University of Warwick and University Hospitals Coventry and Warwickshire (UHCW) NHS Trust in the UK to investigate whether a tailored online exercise and support programme would benefit those experiencing long-term symptoms of Covid-19

Press Release:

  • One of the first clinical trials to investigate treatment for the long-term symptoms of Covid-19 to be led by University of Warwick and University Hospitals Coventry and Warwickshire NHS Trust
  • Researchers are to pioneer a tailored and supervised online exercise and support programme for those experiencing what has been dubbed ‘long Covid’
  • Previous research on similar diseases such as SARS has shown some benefit of exercise rehabilitation for patients

Researchers at the University of Warwick and University Hospitals Coventry and Warwickshire (UHCW) NHS Trust in the UK are to investigate whether a tailored online exercise and support programme would benefit those experiencing long-term symptoms of Covid-19 – what has been dubbed ‘long Covid’.

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Baricitinib plus Remdesivir shows promise for treating COVID-19

This colorized transmission electron micrograph shows a SARS-CoV-2 virus particle, isolated from a patient.

Press release:

The combination of baricitinib, an anti-inflammatory drug, and remdesivir, an antiviral, reduced time to recovery for people hospitalized with COVID-19, according to clinical trial results published in the New England Journal of Medicine. The study was supported by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health.

The clinical trial is the second iteration of the NIH Adaptive COVID-19 Treatment Trial (ACTT-2), a study protocol to evaluate therapeutics for people hospitalized with COVID-19. Remdesivir is a broad-spectrum antiviral treatment developed by Gilead Sciences, Inc. Baricitinib was discovered by Incyte and licensed to Eli Lilly and Company, and marketed under the brand name Olumiant. It is approved in more than 70 countries as a treatment for adults with moderately-to-severely active rheumatoid arthritis. Researchers hypothesized that because many severe symptoms of COVID-19 are caused by a poorly regulated inflammatory response, a therapeutic designed to target inflammation could be helpful for patients. The primary results of this study were first announced in September.

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New online COVID-19 mortality risk calculator could help determine who should get vaccines first

Calculator generates mortality risk estimates for individuals and communities based on sociodemographic info and medical history

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A new online calculator for estimating individual and community-level risk of dying from COVID-19 has been developed by researchers at the Johns Hopkins Bloomberg School of Public Health. The researchers who developed the calculator expect it to be useful to public health authorities for assessing mortality risks in different communities, and for prioritizing certain groups for vaccination as COVID-19 vaccines become available.

The algorithm underlying the calculator uses information from existing large studies to estimate risk of COVID-19 mortality for individuals based on age, gender, sociodemographic factors and a variety of different health conditions. The risk estimates apply to individuals in the general population who are currently uninfected, and captures factors associated with both risk of future infection and complications after infection.

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Political partisanship has had outsized influence on individual social mobility during COVID-19 pandemic

Partisan pandemic: How partisanship and public health concerns affect individuals’ social mobility during COVID-19

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In the United States, political partisanship has played a much stronger role in individuals’ decisions to limit their social mobility during the COVID-19 pandemic than the local incidence of the disease in their own communities, according to a new survey-based study of 1,135,638 million responses collected between April 4 and September 10, 2020 via Survey Monkey from randomly chosen people. The analysis, based on an average of 6,744 responses daily during the study period, suggests partisanship has been roughly 27 times more important than local COVID-19 prevalence for explaining individual mobility. In addition, Joshua Clinton and colleagues also found that self-identified Democrats were 13.1% less likely to be socially mobile compared with independents, while Republicans were 27.8% more likely to be mobile. Notably, this gulf widened over time, driven largely by increasing unwillingness on the part of self-identified Republicans to limit their mobility. The researchers weighted each day’s sample cohort to be representative of the country’s adult population using current estimates from the U.S. Census Bureau’s American Community Survey. Each survey asked respondents to identify their political affiliation (Democrat, Republican, or Independent) and to report whether, in the preceding 24 hours, they had engaged in activities such as going to a restaurant, visiting family or friends, taking a walk, exercising, getting groceries, receiving medical care, or going to work. While the analysis primarily focused on the daily aggregate of all such activities, the researchers also found similar trends among individual activities as well, and further noted that the gap was even more pronounced when looking at riskier, voluntary activities such as eating at a restaurant or visiting with family or friends. “These differences have tremendous consequences for the ability of the United States to limit the spread of COVID-19,” the authors write, further noting that their results “add to a growing consensus that partisanship is a key factor in explaining behavior and attitudes surrounding the COVID-19 pandemic.”

A saliva-based smartphone platform could rapidly expand COVID-19 testing

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Offering an ultrasensitive yet accessible approach to COVID-19 testing, a portable saliva-based smartphone platform provides results within 15 minutes without the resource-intensive laboratory tests the current gold standard requires, according to a new study. The approach was tested in 12 people infected with COVID-19 and 6 healthy controls. Bo Ning and colleagues demonstrate that this technique, which pairs a fluorescence microscope readout device with a smartphone to determine viral load from a CRISPR/Cas12a assay, works as effectively as the well-established quantitative reverse-transcriptase polymerase chain reaction (RT-qPCR) method. “We believe this smartphone platform, a similar future application, offers the potential to rapidly expand COVID-19 screening capacity, and potentially simplify the verification of contact tracing, to improve local containment and inform regional disease control efforts,” the authors write. Most COVID-19 tests currently require swabbing the upper part of the throat behind the nose – an uncomfortable process that requires medical professionals in full protective gear to collect samples in airborne infection isolation rooms before running RT-qPCR tests. However, recent studies have found that SARS-CoV-2 may be equally present in the nasopharynx and the saliva during early infection, suggesting saliva-based COVID-19 tests could enable comparably reliable but simpler, safer testing. To develop a widely accessible platform for saliva-based testing, Ning and colleagues built a prototype assay chip that uses the CRISPR/Cas12a enzyme to enhance an amplified viral RNA target’s signal within a saliva sample. They integrated the chip into a smartphone-based fluorescence microscope readout device, which captures and analyzes images to determine whether the virus is present above a threshold concentration. The researchers used this design to analyze saliva from 12 patients with COVID-19 and 6 healthy controls, finding that the approach successfully distinguished between patients with and without the virus. Additionally, the researchers compared nasal and saliva swabs from non-human primates before and after infection. They found higher SARS-CoV-2 RNA levels in the saliva swabs, further suggesting that saliva may provide a robust means of diagnosis after infection. Ning et al. anticipate that a future version of the chip used in this technique could contain pre-loaded reagents and sample controls, and a custom smartpho

Genes could be key to new COVID-19 treatments, study finds

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Potential treatments for Covid-19 have been identified after the discovery of five genes associated with the most severe form of the disease.

Genetic evidence is second only to clinical trials as a way to tell which treatments will be effective in a disease. Existing drugs that target the actions of the genes reveal which drugs should be repurposed to treat Covid-19 in clinical trials, experts say.

Genes involved in two molecular processes – antiviral immunity and lung inflammation – were pinpointed. The breakthrough will help doctors understand how Covid-19 damages lungs at a molecular level.

Researchers from the University of Edinburgh made the discovery by studying the DNA of 2,700 patients in 208 intensive care units (ICUs) in the UK.

Researchers from the GenOMICC consortium – a global collaboration to study genetics in critical illness – compared the genetic information of Covid-19 patients in ICU with samples provided by healthy volunteers from other studies, such as UK Biobank, Generation Scotland and 100,000 Genomes.

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New report finds global health research infrastructure imperiled by COVID-19

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The strong foundation of global health research and development (R&D) that greatly accelerated the development of COVID-19 innovations is now being weakened by pandemic pressures that are diverting funding and expertise away from other dangerous diseases and putting clinical trials and scientific endeavors around the world on indefinite hold.

That’s a key conclusion of a new report released today from the non-profit Global Health Technologies Coalition (GHTC). It’s based on qualitative interviews with experts in academia, philanthropy, industry, government agencies and product development partnerships discussing how the battle against one all-consuming global health threat–COVID-19–is affecting efforts to combat a wide range of other diseases still sickening and killing millions of people worldwide.

“A lot of veterans of global health R&D are confronting a confounding situation of a pandemic that has generated new appreciation for the value of their work while at the same time potentially causing long-term harm to the field,” said GHTC Director Jamie Bay Nishi. “Global health R&D has always subsisted on thin budgets and a tight-knit coalition of infectious disease experts–and both of these, funding and talent, are being redirected to COVID-19, which is putting many important projects in a precarious position.”

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Unexpectedly, data show that anaesthetists and intensive care doctors are at lower risk of SARS-CoV-2 infection compared with other medical staff

Press release:

Following the first recorded death of an anaesthetist from COVID-19 in the UK in November 2020, a review of available data published in Anaesthesia (a journal of the Association of Anaesthetists) shows that unexpectedly, despite their perceived increased exposure to COVID-19 patients and high-risk procedures, anaesthetists and intensive care doctors appear to be at lower risk of being infected with SARS-CoV-2 and developing COVID-19.

The analysis was carried out by Professor Tim Cook, Consultant in Anaesthesia and Intensive Care Medicine, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK, and School of Medicine, University of Bristol, UK, and Dr Simon Lenanne, General Practitioner, Ross-on-Wye, Herefordshire, UK. The authors undertook the review following the death on November 12, 2020, of anaesthetist Dr Krishnan Subramanian, who was aged 46 years and worked at the Royal Derby Hospital, UK.

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Majority of pregnant women who tested positive for COVID-19 were asymptomatic, study finds

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The majority of pregnant women who tested positive for COVID-19 on arrival to the delivery room were asymptomatic, according to a paper by Mount Sinai researchers published in PLOS One on Thursday, December 10. The pregnant patients who tested positive for the coronavirus were also more likely than those who tested negative to identify as Hispanic and report their primary language as Spanish.

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Access to nature important for mental health during Covid lockdowns

People in European countries with the strictest COVID-19 lockdown policies were more likely to show symptoms of depression and anxiety, according to an international study investigating the impact of disconnecting from nature.

Led by the Basque technology center AZTI, and involving the University of Exeter, the study built on pre COVID-19 evidence that access to outdoor spaces benefitted mental health and wellbeing. Researchers sought to answer the question of whether being forced to disconnect from nature affected mental health. The study, published in the journal Science of the Total Environment, was carried out during the first wave of COVID-19 in Europe (March-May 2020).

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