“Hope is being able to see that there is light despite all of the darkness.” —Desmond Tutu.
“Learn from yesterday, live for today, hope for tomorrow. The important thing is not to stop questioning.” —Albert Einstein.
COVID 19 UPDATES
In the United States there are 30,484,625 Positive Cases, 553,898 Deaths (2%) and 22,683,668 Recoveries (98%). The number of positive cases and deaths are going down over the surge we had back over the Thanksgiving and Christmas Holiday seasons and into the New Year but we must remain vigilant. Not as many of us are vaccinated locally as you may think.
As of March 19,2021, the number of people fully vaccinated in Pennsylvania is 1.4 million. Total population of Pennsylvania 12.8 million. This is about 11% of the state population. Pennsylvania ranks 30th in the U.S. for vaccine roll out.
COVID 19 and the Immunosuppressed: A recent John Hopkins study shows vaccinated individuals who are immunosuppressed may still be susceptible to COVID-19 after vaccination. Previous research has not found that immunosuppressed transplant patients are at increased risk of COVID-19 mortality but the vaccine does not seem to work as well in this same population. This study has not found that immunosuppressed transplant patients are at increased risk of COVID-19 mortality as was thought to be the case. But regardless, the vaccine does not seem to work as well in this population. Two conclusions from this study: First, it seems pretty clear that immunosuppressed individuals need (at least) their second vaccine dose; Second, it is critically important for immunosuppressed individuals to realize that they are not necessarily immune after receiving the vaccine, and to talk to their providers about antibody testing before relaxing protective behaviors.
Mutations and the COVID Virus: Investigators continue to better understand why the novel coronavirus has experienced so many mutations in a short period of time. For example, a coronavirus most often mutates about twice per month, but B117, the United Kingdom-based variant of SARS-CoV-2, experienced more than 20 mutations since it was discovered. Some scientists believe this phenomenon results when people with weakened immune systems, such as those with cancer and diabetes, are infected. Because their immune systems cannot put up much of a fight, the virus easily mutates before it spreads to other individuals. While additional research is necessary, some public health experts suggest that those with compromised immune systems should be vaccinated first.
Why Women Experience COVID and the Vaccines Differently Than Men: Women appear hardwired to experience COVID-19 and the vaccines differently.
Sabra Klein, PhD, a professor at the Johns Hopkins Bloomberg School of Public Health and co-director of the Center for Women's Health, Sex, and Gender Research, reports that it's men in that acute disease that are suffering worse outcomes. When we look at who is being admitted into the intensive care units with severe disease, it is still men. Men are about three times more likely to be admitted into the ICU than are women. This shows women have a more robust immune system than men
This is due to difference of male and female hormones: WOMEN progesterone and estrogen and MEN testosterone. Hormones regulate the functioning of our immune cells. They can turn on responses, they can turn off responses. Testosterone can act as an anti-inflammatory. Testosterone turns off a lot of those initial antiviral, inflammatory types of immune responses that really trigger and lets the male body know that something foreign is there and needs to mount a really protective response. Estrogen and progesterone (Women) turn on this anti-inflammatory response. Therefore, hormones can actually regulate the functioning of our immune cells. They can turn on responses and they can turn off responses depending on your sex.
New Therapeutics for COVID 19: A new drug, Molnupiravir, designed to treat COVID-19 illness is currently in clinical trials with early-stage results recently released. The pill, which does not require refrigeration and is taken orally, showed efficacy at eliminating SARS-CoV-2 in people who tested positive for the novel coronavirus. Initial results of the small study found that symptomatic patients who took molnupiravir were free of the novel coronavirus after 5 days of treatment, compared to 24% of participants who received a placebo. Two other medications—one to treat severe COVID-19 illness and one to help patients with mild symptoms—are also in development.
Aspirin may reduce complications due to COVID 19 Infection: A daily dose of aspirin may help reduce the risk of serious complications from COVID-19. Researchers from the University of Maryland School of Medicine examined the records of 412 adults with COVID-19 who were admitted to hospitals across the United States between March and July.
Slightly more than 23 percent of the people who were studied were given a daily low dose of aspirin within 24 hours of their admission to the hospital or in the 7 days prior to their admission.
The researchers reported that people taking aspirin were 44 percent less likely to be put on a ventilator and 43 percent less likely to be admitted to the intensive care unit (ICU).
The researchers also reported that those who took aspirin had a 47 percent decrease in risk of dying from COVID-19 when compared with those studied who were not taking a daily dose of aspirin.
“Our analysis suggests that aspirin use may have beneficial effects in patients with COVID-19,” the study authors wrote in their study.
“The results of our study are intriguing, especially because aspirin has been thoroughly studied in chronic cardiovascular disease, has a well-described safety profile, and is readily available throughout the world,” they added.
People with COVID-19 are at an increased risk of blood clots, particularly if they are in the ICU.
Some studies suggest between 30 percent and 70 percent of people with COVID-19 in the ICU will develop blood clots in the legs or lungs.
“This is part of the inflammatory response and… involves the lining of blood vessels, particularly small, medium-sized blood vessels,” explained Dr. William Schaffner, an infectious disease expert at Vanderbilt University in Tennessee. “When that happens, the blood that flows through, it gets a little bit sluggish and begins to clot; and when that happens, that’s not good because the tissues supplied by those blood vessels are deprived of oxygen, and if the clots are in sufficiently large vessels, they can break off and cause strokes and heart attacks.”
Aspirin could be useful as an anti-inflammatory drug that could lessen the body’s inflammatory response to COVID-19 as seen in phase two of the illness, Schaffner told Healthline.
But it can’t be used to prevent the virus.
Diabetes and COVID 19: COVID-19 appeared to increase risk of mortality in people hospitalized with diabetic ketoacidosis (DKA), researchers reported. In-hospital mortality also varied according to age, they stated in a research letter in JAMA Network Open. For patients over 65, inpatient mortality was 45% for those with COVID-19 versus 13% without. In patients younger than 45, these rates were 19% versus 2%, respectively. Patients with COVID-19 had a three times higher rate of acute kidney injury during an episode of DKA, at 30% versus 10% among those without COVID-19, the authors reported.
Until next time Stay Safe, Stay Well, Stay Distant, Avoid Crowds and Wear Your Mask
James A. Vito, D.M.D.