London- A team of researchers has discovered that the more severely a mother is infected with Covid-19, the more likely she is to experience preterm birth.
The researchers reported that the rate of preterm birth in nearly 1,000 pregnant women, who tested positive for SARS-CoV-2, the virus that causes Covid-19, was a function of the severity of infection.
"The more severe the SARS-CoV-2 infection, the greater the risk of preterm birth," said researcher Roberto Romero from the Wayne State University School of Medicine in the US.
"There was a dose-dependent relationship between the severity of SARS-CoV-2 infection and the risk of prematurity," Romero added.
For the study published in the American Journal of Obstetrics and Gynecology, the team included data from 14 National Health Service (NHS) maternity hospitals in the UK to assess the effects of SARS-CoV-2 infection in pregnancy.
The excess rate of premature birth, they report, is largely due to medically-induced preterm birth brought about by concerns for health of the mother, such as preeclampsia.
Preterm birth, the leading cause of perinatal morbidity and mortality worldwide, is defined as one that occurs before 37 weeks of gestation.
Two-thirds of preterm births are due to the spontaneous onset of preterm labour. The remaining third is due to medical conditions that affect either the mother or the unborn baby that necessitate delivery.
The more severe the Covid-19 infection, the greater the risk of preeclampsia, a sudden increase in blood pressure after the 20th week of pregnancy.
The condition is responsible for 76,000 maternal deaths and more than 5,00,000 infant deaths every year.
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London- Researchers have identified an anti-viral gene that impacts the risk of both Alzheimer's disease and severe Covid-19.
A team from the University College London (UCL) estimated that one genetic variant of the OAS1 gene increases the risk of Alzheimer's disease by about 3-6 per cent in the population as a whole, while related variants on the same gene increase the likelihood of severe Covid-19 outcomes.
"While Alzheimer's is primarily characterised by harmful build-up of amyloid protein and tangles in the brain, there is also extensive inflammation in the brain that highlights the importance of the immune system in Alzheimer's. We have found that some of the same immune system changes can occur in both Alzheimer's disease and Covid-19," said lead author Dr Dervis Salih, from UCL's Queen Square Institute of Neurology and UK Dementia Research Institute.
"In patients with severe Covid-19 infection, there can also be inflammatory changes in the brain. Here we have identified a gene that can contribute to an exaggerated immune response to increase risks of both Alzheimer's and Covid-19," Salih added, in the paper published in the journal Brain.
To understand the gene's link to Alzheimer's, the team sequenced genetic data from 2,547 people, half of whom had the brain disorder.
They found that people with a particular variation, called rs1131454, of the OAS1 gene were more likely to have Alzheimer's disease, increasing carriers' baseline risk of Alzheimer's by an estimated 11-22 per cent.
The new variant identified is common, and it has a bigger impact on Alzheimer's risk than several known risk genes, the researchers said.
Further, the researchers investigated four variants on the OAS1 gene, all of which dampen its expression (activity).
They found that the variants increasing the risk of Alzheimer's are linked (inherited together) with OAS1 variants recently found to increase the baseline risk of needing intensive care for Covid-19 by as much as 20 per cent.
That is, the microglia cells where OAS1 gene was expressed more weakly had an exaggerated response to tissue damage, unleashing what they call a 'cytokine storm,' which leads to an autoimmune state where the body attacks itself, the team said.
OAS1 activity changes with age, so further research into the genetic network could help to understand why older people are more vulnerable to Alzheimer's, Covid-19, and other related diseases, they added.
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Bhopal- A team of scientists at the Indian Institute of Science Education and Research (IISER) Bhopal have in a review identified the biomolecular relationships between Covid-19, ageing, and diabetes.
The review, published in the journal Molecular and Cellular Biochemistry, presented that existing drugs used to treat diabetes, obesity and ageing can potentially be used to treat Covid-19. Similar naturally existing biomolecules were also explored in combination for the Covid treatment.
"There are classes of compounds such as polyphenols found in plant-based food, curcumin (found in turmeric), and resveratrol (found in grapes), have been shown to not only slow down the ageing process, but also possess anti-viral properties," said Dr. Amjad Husain, Principal Scientist, and CEO of Innovation and Incubation Center for Entrepreneurship (IICE), IISER Bhopal, in a statement.
Some other polyphenols that the researchers have identified as being useful for both Covid-19 treatment and comorbidity conditions such as diabetes and ageing may include catechins (present in green tea, cocoa and berries), procyanidins (found in apples, cinnamon and grape skin), and theaflavin (found in black tea).
The researchers also present evidence of some existing potential anti-ageing drugs such as Rapamycin that can be explored for the Covid-19 treatment because of the common biochemical pathways associated with these diseases. Another such example is a drug Metformin , which is usually used to control blood sugar.
The review showed that at the molecular level, there are intersecting pathways that are common to diabetes, ageing, and Covid-19. All three conditions are associated with oxidative stress and lowering of the immune response and complications arising from them lead to the onset of numerous other diseases such as cardiovascular disorders, eye diseases, neuropathy (nerve diseases), and nephropathy (kidney problems).
The researchers believe that an ideal therapeutic candidate for Covid-19 should be able to target the pathways that are common to diabetes, ageing and the SARS-CoV-2 infection.
Further, computational studies showed that lipids present in cell membranes play an important role in coronavirus infectivity.
Natural compounds such as polyphenols may affect the binding of the virus to host receptors and the molecular interactions required for virus replication and release, thereby stopping the infection in its early stages, the team explained.
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London- While people with diabetes are no more likely to contract Covid-19 than others, they are more likely to become severely ill if they do catch it.
Research presented at the annual meeting of the European Association for the Study of Diabetes (EASD) has shown that certain characteristics put some people with diabetes at higher risk of serious illness and death than others.
An analysis of over 1,000 patients by researchers from the NHS Foundation Trust, England, showed that those with Type 2 diabetes were 2.5 times as likely to die within seven days of admission as those with other types of diabetes.
This may be because Type 2 diabetes usually occurs in older people and can be accompanied by other long-standing health conditions, putting them at higher risk of poorer outcomes, the team explained.
Further, those who had insulin infusions were, half as likely to die as those who didn't need IV insulin, showing that better blood sugar control can improve outcomes in patients with severe Covid and diabetes.
The study included 1,004 patients with an average age of 74.1. About 7.5 per cent were admitted to intensive care and 24 per cent died within seven days of admission to the hospital.
The risk of death was also 2.74 times higher among under-70s with chronic kidney disease than those without.
"According to several studies, patients with diabetic kidney disease have a chronic pro-inflammatory state and immune dysregulation, making it difficult to 'fight off' the virus compared to someone who has a properly working immune system," said Llanera, who has recently moved to Imperial College London.
"In addition, ACE2 receptors are upregulated in the kidneys of patients with diabetic kidney disease. These are molecules that facilitate the entry of SARS-COV-2 into the cells. This may lead to a direct attack of the kidneys by the virus, possibly leading to worse overall outcomes, he noted.
The combination of older age and high CRP (a marker of inflammation) was linked to a more than three-fold (3.44) higher risk of death by Day 7.
The higher CRP correlates with a high degree of inflammation, which can eventually lead to organ failure, the researchers said.
The data has been used to create a model, which, if applied to a patient with similar demographic characteristics, can predict a higher risk of death in seven days using only age and CRP as variables.
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New York - Women who contract Covid-19 during pregnancy are at significantly higher risk of developing pre-eclampsia, the leading cause of maternal and infant death worldwide, according to a new study.
Pre-eclampsia is a sudden increase in blood pressure after the 20th week of pregnancy.
The study, published in the American Journal of Obstetrics and Gynecology, showed that women with SARS-CoV-2 infection during pregnancy had 62 per cent higher odds of developing preeclampsia than those without the infection during pregnancy.
"This association was remarkably consistent across all predefined subgroups. Moreover, SARS-CoV-2 infection during pregnancy was associated with a significant increase in the odds of pre-eclampsia with severe features, eclampsia and HELLP syndrome," said Roberto Romero, Professor of Molecular Obstetrics and Genetics at the Wayne State University School of Medicine.
HELLP syndrome is a form of severe pre-eclampsia that includes hemolysis (the rupturing of red blood cells), elevated liver enzymes and a low platelet count.
The team published their findings after reviewing 28 previous studies that included 790,954 pregnant women, including 15,524 diagnosed with Covid-19 infection.
"Both asymptomatic and symptomatic infection significantly increased the risk of pre-eclampsia," Romero said.
"Nevertheless, the odds of developing pre-eclampsia were higher among patients with symptomatic illness than among those with asymptomatic illness."
Pre-eclampsia warning signs, in addition to elevated blood pressure, can include headaches, swelling in the face and hands, blurred vision, chest pain and shortness of breath.
The condition is responsible for 76,000 maternal deaths and more than 500,000 infant deaths every year, according to estimates from the Pre-eclampsia Foundation.
The babies of pre-eclamptic mothers are affected by the condition and may develop intrauterine growth restriction or die in utero.
The researchers said health care professionals should be aware of the association and closely monitor pregnant women who are infected for early detection of pre-eclampsia.
A separate study, published in the American Journal of Obstetrics and Gynecology-Maternal-Fetal Medicine, showed that women who receive the mRNA Covid-19 vaccine during pregnancy pass high levels of antibodies to their babies.
The study of 36 newborns whose mothers received either the Pfizer-BioNTech or Moderna Covid-19 vaccine during pregnancy showed that 100 per cent of the infants had protective antibodies at birth.
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कोविड ने गैर-संचारी रोगों के रोगियों के लिए जटिलताओं और स्वास्थ्य जोखिमों को कई गुना बढ़ा दिया है। लगभग 75-80 प्रतिशत कोविड रोगियों को अस्पताल में भर्ती होने की आवश्यकता नहीं होती है। वे घर पर टेलीकंसल्टेशन से ठीक हो सकते हैं, लेकिन कोविड-19 संक्रमण रोगी को दीर्घकालिक दुष्प्रभावों के साथ छोड़ सकता है। ऐसे कई उदाहरण हैं जहां कोविड-19 के लक्षण कई महीनों से बने हुए हैं। फेफड़ों को नुकसान पहुंचाने के अलावा, वायरस तीव्र मायोकार्डियल चोट और हृदय प्रणाली को पुरानी क्षति भी पहुंचा सकता है।
यूरोपियन हार्ट जर्नल में प्रकाशित शोध के अनुसार, कार्डिएक अरेस्ट से पीड़ित कोविड-19 रोगियों की मृत्यु की संभावना उन लोगों की तुलना में अधिक होती है, जो इससे संक्रमित नहीं होते हैं, और विशेष रूप से महिलाओं में इसी कारण से मृत्यु का खतरा अधिक होता है। वायरस सीधे मायोकार्डियम ऊतक के भीतर एसीइ2 रिसेप्टर कोशिकाओं को भंग कर सकता है और सीधे वायरल नुकसान का कारण बन सकता है। कोविड के परिणाम स्वरूप हृदय की मांसपेशियों में सूजन हो सकता है जिसे मायोकार्डिटिस के रूप में जाना जाता है । यदि समय पर ध्यान न दिया जाए तो यह हृदय की विफलता का कारण बन सकता है।
पहले से हृदय रोग से पीड़ित लोगों को अतिरिक्त सावधानी बरतने की जरूरत है। ठीक होने की अवधि के दौरान बड़ी संख्या में रोगियों को कार्डियक अरेस्ट हुआ है, जिसके परिणामस्वरूप अक्सर मृत्यु हो जाती है। विशेषज्ञ सुझाव देते हैं कि भले ही कोविड वायरस कम हो जाए, लेकिन प्रतिरक्षा प्रतिक्रिया अति-सक्रिय बनी रहती है। यह अक्सर अन्य अंगों पर हमला करती है। यह देखा गया है कि इनमें से लगभग 80 प्रतिशत रोगियों को कोरोना पॉजिटिव परीक्षण के 2-3 सप्ताह बाद दिल का दौरान पड़ा है।
हम कुछ चेतावनी के संकेतों को नजरअंदाज कर देते हैं और जागरूकता की कमी के कारण, कभी-कभी, हम कोविड के दौरान या कोविड से ठीक होने के बाद भी कुछ हृदय संबंधी समस्याओं को रोकने में विफल होते हैं। किसी को कोविड-19 हो जाने के बाद, यदि वह रोगी तेज दिल की धड़कन या धड़कन का अनुभव कर रहा है, तो उसे तुरंत डॉक्टर से संपर्क करने की सलाह दी जाती है क्योंकि हृदय गति में एक अस्थायी वृद्धि भी कई अलग-अलग चीजों का संकेत दे सकती है, जिसमें बहुत बीमार होने के बाद भी शामिल है।
यह सुनिश्चित करना आवश्यक है कि रोगी पर्याप्त तरल पदार्थ पी रहा है, खासकर यदि बुखार है। कभी-कभी, जो लोग कोविड से ठीक हो रहे हैं, उनमें पोट्स (पोस्टुरल ऑर्थोस्टैटिक टैचीकार्डिया सिंड्रोम) नामक स्थिति के लक्षण दिखाई दे सकते हैं। हालाँकि, ढडÝर और उडश्कऊ के विकास के बीच की कड़ी अभी तक स्थापित नहीं हुई है। हालाँकि, पोट्स एक तंत्रिका संबंधी समस्या है, और यह सीधे तौर पर हृदय संबंधी समस्या नहीं है। यह तंत्रिका तंत्र के हिस्से को प्रभावित करता है और हृदय गति और रक्त प्रवाह में बाधा उत्पन्न कर सकता है। खड़े होने पर सिंड्रोम भी तेजी से दिल की धड़कन पैदा कर सकता है।
कोविड रिकवरी के बाद दिल का दौरा पड़ने के कई उदाहरणों ने हृदय स्वास्थ्य की लगातार निगरानी के महत्व पर जोर दिया है। विशेषज्ञों के अनुसार, मधुमेह और उच्च रक्तचाप जैसी पहले से मौजूद स्थितियों वाले उच्च जोखिम वाले व्यक्तियों में ईसीजी, एक्स-रे चेस्ट और लिपिड प्रोफाइल जैसे हृदय परीक्षण हर छह महीने में दोहराए जाने चाहिए ताकि यह पता लगाया जा सके कि हृदय को कोई नुकसान हुआ है या नहीं। नियमित निगरानी के अलावा, कोविड के बाद के रोगियों को सभी आवश्यक पोषक तत्वों से युक्त स्वस्थ आहार का पालन करना चाहिए और मसालेदार, तैलीय, डिब्बाबंद, कृत्रिम मिठास और प्रसंस्कृत स्वाद, या जंक फूड से सख्ती से बचना चाहिए। शारीरिक व्यायाम के लिए समय निकालना, शराब और धूम्रपान को कम करना आवश्यक है। यहां तक कि छोटे से छोटे लक्षणों को भी ध्यान में रखा जाना चाहिए और तुरंत एक विशेषज्ञ चिकित्सक को दिखाना चाहिए।
यह भी पढ़े► कोविड प्रकोप के कारण बच्चों में सीखने की हानि हुई : डॉ. के. कस्तूरीरंगन