New York- Covid-19 infection during pregnancy leads to distinct immune changes in mothers and babies, according to a study.
The researchers found that Covid-19 dysregulates maternal immune response, with different immune signatures between mothers with asymptomatic and severe disease.
"We know that pregnancy increases maternal risk for Covid-19, but relatively little is known about the long-term consequences of in-utero exposure for infants," said Jae Jung, Director of the Cleveland Clinic Global Center for Pathogen & Human Health Research.
The study highlights "how important it will be for long-term follow-up after pregnancy to catch and hopefully prevent any unforeseen long-term health conditions related to prenatal infection,"Jung added.
For the study, published in the journal Cell Reports Medicine, the team involved 93 mothers with Covid-19 and 45 of their infant children who were exposed to SARS-CoV-2, the virus that causes Covid-19.
The research team studied immune profiles for more than 1,400 cytokines and other inflammatory proteins collected from peripheral and cord blood samples.
The researchers compared maternal blood specimens collected close to the initial detection of SARS-CoV-2 and at different time points throughout pregnancy and delivery.
They found that compared to mild or moderate disease, pregnant women with severe Covid-19 exhibited significantly more inflammation and elevated levels of a protein called IFNL1 (interferon lambda 1) and the receptor it binds with, IFNLR1, which plays a critical role in protecting against viruses.
"This increase in interferon lambda signaling may help explain why we see relatively little direct transmission of Covid-19 between mother and baby during the period right before or after birth -- what we call vertical transmission," explained Suan-Sin (Jolin) Foo, a research associate in Dr. Jung's lab and co-first author on the paper.
Despite the lack of evidence for robust vertical transmission, the researchers found that SARS-CoV-2 infection alters maternal immunity at delivery and that gestational SARS-CoV-2 exposure alters infant immunity at birth.
At delivery, the women exhibited dysregulated levels of several cytokines that are associated with pregnancy complications, including MMP7, MDK, ESM1, BGN and CD209.
Among infants, prenatal exposure induced the expression of cytokines related to T cells, which are a type of immune cell involved in recognising and attacking specific antigens.
The majority of births within the cohort were healthy, but there was a high incidence of some complications, including preeclampsia and foetal growth restriction.
More research will be necessary to understand the extent to which the observed immune changes are related to these clinical outcomes, the team said.
Read More► How Covid-19 Exposed Vulnerability in People With Diabetes
While wearing double masks, which helps create a strong barrier against Covid-19 infection spread via airborne viral particles, has become the new normal, prolonged wearing of masks can develop hydration issues or other nagging breathing troubles, health experts said on Wednesday.
There has been enough evidence through the pandemic to show the importance of masks for effective pandemic control. At the start of the pandemic, it was seen that countries (primarily Asian nations) which enforced early masking had lesser mortality rates as compared to countries in the West where compulsory mask wearing was introduced quite late.
"Prolonged mask wearing can be associated with certain problems the most common being headaches, dehydration, acne and difficulty in breathing," Radhika Banka, Consultant Pulmonologist at P.D. Hinduja Hospital & MRC, Mumbai, told IANS.
Breathing issues are "usually seen in mouth breathers and in people with underlying respiratory problems such as COPD (Chronic Obstructive Pulmonary Disease)", she added.
According to Ravi Shekhar Jha, Additional Director and HOD, Pulmonology, at Fortis Escorts Hospital, Faridabad, wearing double mask for long hours can also lead to dryness.
"It is because natural humidification of nasal mucosa gets impaired," Jha said.
There are various masks available in the market, including cloth masks, surgical masks and respirators such as N-95s.
The cloth mask has the least protection and the US Centre of Disease Control and Prevention (CDC) recommends wearing a disposable surgical mask along with a cloth mask for additional protection. For surgical masks, the knotted technique (that is knotting the ear loops to provide better fit and prevent leakage from the sides) is recommended.
But with full vaccination rolled out in most countries, are double masks still required?
"Even after double dose vaccination, people can get breakthrough infections and can still be asymptomatic carriers and spread the infection. Hence masking is important even after double vaccination," Banka said.
The health experts stated that for people living in India, double masks become more important as vaccination of children has not yet begun in the country, and asymptomatic transmission is the highest from children. Added to this is a high population density, where social distancing is not practically possible in many cases.
Most of the countries which have made masks voluntary are those in the West with low population density, where social distancing is feasible. These countries have managed to vaccinate more than 80 per cent of their population with two doses. Also, masks in these countries are still recommended in enclosed spaces, public transports, healthcare facilities etc.
"With only 48 per cent of our population being vaccinated with one dose and 25 per cent being vaccinated with two doses, I do not think India can yet take the risk of removing the mandatory use of masks," Banka said.
However, according to Jha, "A single mask, if worn properly, is sufficient."
"People who wear double masks, have this tendency of adjusting their masks repeatedly due to breathing issues, and that way the whole purpose of wearing a mask is defeated," he said.
Jha added that for someone like a healthcare worker, who is in an area with high concentration of Covid viral droplets, an N-95 mask should be worn all the time. For other situations, a normal surgical mask (single) is sufficient.
"We need to ensure that masks are worn properly, with proper seal at nose. Improperly worn masks are more dangerous. It is also important to keep in mind that a mask alone may not protect. One needs to follow hand hygiene as well as maintain social distancing," Jha advised.
Although several countries have loosened mask restrictions citing vaccine efficacy, various studies and health experts have stressed on the need for continuing wearing masks, even after being fully vaccinated, including booster shots; and following other protective measures such as physical distancing and handwashing.
A recent study led by researchers from the Monash University and the University of Edinburgh analysed more than 30 studies from around the world and found a statistically significant 53 per cent reduction in the incidence of Covid with mask wearing, and 25 per cent reduction with physical distancing. Handwashing also indicated a substantial 53 per cent reduction in Covid incidence.
Most people are able to wear masks fairly well for a few hours, but if your job requires you to wear masks for a prolonged period, it is essential to take adequate breaks to hydrate oneself and prevent any skin problems, Banka suggested. (Agency)
Read More► 4 Ways Psoriasis Can Worsen If Not Managed Well
While Covid-19 spared none, people with diabetes were among the hardest hit. The infectious disease not only raised the risk of severe disease progression and death among diabetics, affecting even the recovery, it also contributed towards the burden of diabetes in the country.
World Diabetes Day is observed annually on November 14 to raise awareness on the high blood sugar condition and related consequences.
India, known as the diabetes capital of the world, is home to one in six diabetics in the world. The country has also suffered significantly from Covid-19.
While on an average, diabetes reduces life expectancy by 4-10 years increasing the risk of death due to other comorbidities, which include heart attacks, kidney failures and infections, Covid infection fast forwarded that among people with diabetes.
Diabetes increased inflammatory response among Covid patients, spiking their blood sugar levels. It then complicated the course of Covid, resulting in excess morbidity and mortality, as well as posing severe challenges in the recovery of patients.
"During Covid patients were succumbing to it, not because of the original disease, but because despite all other efforts their glucose levels remained high. Thus recognising glucose as a vital sign very similar to blood pressure and pulse rate, respiratory rate, became more necessary during the pandemic," Jothydev Kesavadev from Jothydev's Diabetes Research Centres, Kerala, told IANS.
"Studies from all over the world show that the majority of the deaths from Covid were linked to high glucose values, and this includes both patients with no diabetes and with the new onset of high glucose," he added.
Further, the use of steroids, to control the serious manifestations of Covid-19, worsened the glucose levels in the patients.
High blood sugar levels, coupled with increased use of steroids, also led to other complications such as an unprecedented surge in cases of mucormycosis, commonly known as black fungus. It is a fungal infection, which occurs by inhalation of spores and can disseminate to various organs rapidly.
According to a recent study, published in Diabetes and Metabolic Syndrome: Clinical Research and Reviews, more than 86 per cent of mucormycosis or black fungus cases related to Covid in India, had uncontrolled glucose values.
"While the Covid cases are closely related to diabetes, mucormycosis is also very closely related to diabetes in Covid. Whenever the glucose is high, there is a deranged immune mechanism and in the presence of an infection it is persuaded rapidly," Kesavadev said.
Another study, published in the same journal showed that people with Type-2 diabetes who also suffered Covid-19 were more likely to experience severe fatigue than those who did not have the infectious disease, emerging as a major roadblock in the recovery of patients infected with SARS-CoV-2.
Moreover, among diabetes patients, those with increased fatigue level post Covid-19 also had increased postprandial blood glucose levels.
Covid also contributed to new onset of diabetes in many people, particularly the young. On one hand, Covid-induced lockdowns increased diabetes cases as people spent more time indoors, while eating more and exercising less.
On the other hand, Covid also contributed to nearly 25 per cent rise in diabetic patients in the country, according to an analysis of OPD data from a private hospital in Delhi.
Doctors found that among patients with confirmed Covid-19 infections, there was nearly 25 per cent of new onset of diabetic patients. Stress induced hyperglycemia -- high blood sugar -- was seen in 10 per cent of patients who had Covid-19 infection.
"The younger population is increasingly affected. We have seen that happening during Covid-19 epidemic. Increasing number of young people with more severe diabetes are now being seen," Dr Anoop Misra, Fortis-C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, New Delhi, told IANS.
As per a recent study, among the younger generation in India, below the age of 30 years, there is a rapid increase in the occurrence of diabetes over the last 10 years.
"For these, diabetes as a disease will result in complications after 10 to 15 years. Imagine a situation where more and more people are developing diabetes at the age of 25 years or 30 years, which means even during the productive age group, by the time they are 35 years or 40 years, they will start developing complications. if the disease is not treated properly," Kesavadev said.
"There is an urgent need to decrease the screening age of diabetes to 25 years, from the current 30 years, in India," Dr Misra said, adding that "there is increasing urgency to ensure that young people follow correct lifestyle practices including more exercise, correct food choices, and maintenance of weight to normal, or even leaner category".
While diabetes cannot be treated it can be controlled and reversed by adopting a healthy lifestyle, diet and having proper sleep, as well as exercising for at least half an hour every day, suggested the experts. (Rachel V Thomas)
Read More► Proteins in Covid Virus That Damage Blood Vessels Found
Chronic inflammation caused by obesity may trigger the development of cells that break down bone tissue, including the bone that holds teeth in place, finds a new research.
The study, completed in an animal model, found that excessive inflammation resulting from obesity raises the number of myeloid-derived suppressor cells (MDSC), a group of immune cells that increase during illness to regulate immune function.
MDSCs, which originate in the bone marrow, develop into a range of different cell types, including osteoclasts (a cell that breaks down bone tissue).
"This research promotes the concept that MDSC expansion during obesity to become osteoclasts during periodontitis is tied to increased alveolar bone destruction," said researcher K.H. Kwack from the University at Buffalo.
"Taken together, this data supports the view that obesity raises the risk of periodontal bone loss," Kwack added.
Bone loss is a major symptom of gum disease and may ultimately lead to tooth loss.
Also known as periodontal disease, gum disease affects more than 47 per cent of adults 30 years and older, according to the Centers for Disease Control and Prevention.
For the study, published in the Journal of Dental Research, the team examined two groups of mice fed vastly different diets over 16 weeks -- one group, a low-fat diet that derived 10 per cent of energy from fat, the other group a high-fat diet that drew 45 per cent of energy from fat.
The investigation found that the high-fat diet group experienced obesity, more inflammation and a greater increase of MDSCs in the bone marrow and spleen compared to the low-fat diet group.
The high-fat diet group also developed a significantly larger number of osteoclasts and lost more alveolar bone (the bone that holds teeth in place).
Also, the expression of 27 genes tied to osteoclast formation were significantly elevated in the group fed a high-fat diet.
Read More► Gene Linked to Cognitive Resilience in Elderly Identified
Delhi's Lok Nayak Jai Prakash Hospital has seen a growth of 8 to 10 per cent in patients suffering with respiratory problems due to pollution after Diwali, its Medical Director Dr Suresh Kumar said on Sunday.
Talking to IANS, Dr Suresh Kumar said that they everyday have 10-12 patients visiting the hospital with breathing problems.
"Air pollution has become a major issues post Diwali. Elderly people and chlidren are the main victim of the pollution," he said, adding that long-term exposure to chronically high PM 2.5 levels weakens the lungs' ability to function.
The air quality in Delhi improved marginally on Sunday from Saturday's "severe" to "very poor category". According to the forecast from the Air Quality Early Warning System, the AQI will continue to remain in the "very poor" category till at least Tuesday.
About the pollution caused respiratory and other problems, Dr Kumar said that they have capacity for 120 patients but due to the outbreak in pollution-related diseases post Diwali, they are getting around 140 patients every day in the hospital.
He said the emergency and OPD wards are getting average 140 patients in total, with all types of problems, but most of them are suffering with respiratory and dipping levels of oxygen. It also includes the rising number of asthma cases in children.
About the preventive measures, he said that only two things - use of masks and avoiding stepping outside - can protect people from such rising level of pollution.
He added that the high level of PM 2.5 particles at this time can lead to lung infections, irritation in eyes, and respiratory problems.
Read More► Is Pregnancy Related Low Back Pain Sciatica?
An immediate challenge today is the prevention of Diabetes among the youth and pregnant women, Union Minister of State Dr. Jitendra Singh said on Sunday.
The minister, also a renowned Diabetologist, called for a mandatory diabetes test in all maternity hospitals and for every pregnant women, adding that more than 70 per cent of India's population is below 40 years of age.
Calling for an integrated and holistic approach to fight Diabetes, Singh said: Covid has prompted us to discover new norms in adversity and underlined the importance of combining traditional Indian management modalities with the Allopathic System."
"Diabetes is a growing epidemic globally and more so in India. A total of 88 million adult populations in India has diabetes in 2019 as per the latest International Diabetes Federation (IDF) estimates and this is projected to rise by almost 74 per cent to 153 million by 2045, giving India the dubious distinction of becoming the diabetes capital of the world," Singh said.
Sharing the concerns about of Diabetes that is making fast inroads in rural India with huge economic bearing on poor families, Singh said that there is a need to popularise Telemedicine to provide easy and affordable access to the ailing population.
Talking about the National Digital Health Mission, Singh said it can revolutionise healthcare in India as citizens will be issued a health card that will have all their medical information.
He said, the details of medical tests, illnesses, doctors' prescriptions and medical reports will be on a single identity card and will be the first of its kind in the world.
The Union Minister was speaking at a webinar on diabetes on the occasion of World Diabetes Day, jointly organized by Swami Vivekananda Yoga Anusandhana Samasthana, S-VYASA, Bengaluru and Central Council for Research in Yoga and Naturopathy, CCRYN, New Delhi.
Read More► Breast Cancer a Life Changing Reality