Covid 19 Disease Severity

New York: People hospitalised during the pandemic both for Covid and other conditions have a higher rate of antibiotic-resistant bacterial infections compared to patients hospitalised before the pandemic, according to a study. An estimated 1.2 million people worldwide died in 2019 from antibiotic-resistant infections, and this number is predicted to increase ten-fold by 2050. There have been studies reporting that the pandemic was associated with antimicrobial resistance (AMR) secondary infections, possibly due to the increase in the use of antibiotics to treat Covid-19 patients and disruptions to infection prevention and control practices in overwhelmed health systems. The study, presented at this year's European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) being held in Portugal, evaluated the pandemic's impact on antimicrobial resistance (AMR) in 271 hospitals across the US. The researchers assessed AMR rates per 100 hospital admissions before and during the Covid pandemic, and examined whether drug-resistant infections were acquired in the community-onset setting (defined as a culture collected less than two days after admission) or in the hospital-onset setting (more than two days after admission). In total, 1,789,458 patients were admitted to the hospital in the pre-pandemic period and 3,729,208 during the pandemic. The number of patients admitted to the hospital with at least one AMR infection was 63,263 in the pre-pandemic period and 129,410 during the pandemic. Patients who tested positive or negative for Covid had higher levels of AMR than patients before the pandemic, 4.92 per 100 admissions and 4.11 per 100 admissions, respectively. For hospital-associated infections, the AMR rate was 0.77 per 100 admissions before the pandemic and 0.86 per 100 admissions during the pandemic, and highest at 2.19 per 100 admissions in patients with Covid-19. When looking at community-onset infections, the AMR rate was 2.76 per 100 admissions in the pre-pandemic period, and 2.61 per 100 admissions during the pandemic. "These new data highlight the importance of closely monitoring the impact of Covid-19 on antimicrobial resistance rates, said Dr Karri Bauer from the US pharmaceutical company Merck. "It is particularly worrying that antibiotic resistance has been rising during the pandemic in both SARS-CoV-2 positive and negative patients. Hospital-acquired infections are a major concern, with antimicrobial resistance rates significantly higher during the pandemic than before," he added. (Agency) Read More► Omicron Ups Risk of Upper Airway Infections, Cardiac Arrest in Small Kids

The SARS-CoV-2 virus can directly infect a specialised type of kidney cell, explaining why acute kidney injury is one of the main complications observed in patients with severe Covid-19, finds a study. Primarily known to infect cells in the respiratory tract, physicians were surprised to see that many patients, especially those with severe Covid, were also developing injuries to their kidneys. "It was shocking to hear doctors describe how patients who were healthy suddenly developed kidney injury and needed to go on dialysis after contracting SARS-CoV-2," said Samira Musah, assistant professor of biomedical engineering and medicine at Duke University. "It was clear that the virus was doing something to the kidneys, but it was so early in the pandemic that nobody was sure what was going on," she added. For the new study, described in the journal Frontiers in Cell and Developmental Biology, the team worked worked with a pseudovirus version of SARS-CoV-2 on a previously developed model of podocyte cell, a specific type of kidney cell that helps control the removal of toxins and waste from the blood. When the pseudovirus was introduced to the podocyte cell model, the team discovered that the spike protein of the virus could directly bind to numerous receptors on the surface of podocytes. "We found that the virus was especially adept at binding to two key receptors on the surface of the podocytes, and these receptors are abundant in these kidney cells," explained Titilola Kalejaiye, a postdoctoral fellow at Duke. "There was a strong uptake of the virus initially, and we also found that when you increased the dose of the virus, the uptake would increase even further. The virus seemed to have a strong affinity for these kidney cells." Further, the team tested their podocyte model with the real SARS-CoV-2 virus. Just like with the pseudovirus, the team observed that the live version of the virus had a strong affinity for podocytes. Once the virus infected the cells, it damaged the podocytes, causing their long, finger-like structures, which help filter blood, to retract and shrivel. If the injuries to the cells were too severe, the podocytes would die. "Beyond the structural damage, we saw that the virus could hijack the machinery of the podocytes to produce additional viral particles that could spread to infect additional cells," said Maria Blasi, Assistant Professor of medicine at Duke. Now the team hopes to expand their work to study how the different variants of SARS-CoV-2 behave in kidney cells. Read More► Omicron Ups Risk of Upper Airway Infections, Cardiac Arrest in Small Kids