New York, July 22 (IANS) Adults and children with Covid-19 who have a history of malnutrition may have an increased likelihood of death and the need for mechanical ventilation, according to a study.
Malnutrition hampers the proper functioning of the immune system and is known to increase the risk of severe infections for other viruses, but the potential long-term effects of malnutrition on Covid-19 outcomes are less clear, said Louis Ehwerhemuepha from Children's Hospital of Orange County in California, US.
Children older than five and adults aged 18 to 78 years with previous diagnoses of malnutrition were found to have higher odds of severe Covid-19 than those with no history of malnutrition in the same age groups.
Children younger than five and adults aged 79 or above were found to have higher odds of severe Covid-19 if they were not malnourished compared to those of the same age who were malnourished. In children, this may be due to having less medical data for those under five, according to the researchers.
The risk of severe Covid-19 in adults with and without malnutrition continued to rise with age above 79 years. The findings are published in the journal Scientific Reports.
Malnutrition, as a global health problem for both the pediatric and adult population, will continue to overlap with the Covid-19 pandemic that has already affected millions worldwide, Ehwerhemuepha said.
The researchers suggest that public health interventions for those at highest risk of malnutrition may help mitigate the higher likelihood of severe Covid-19 in this group.
For the study, the team investigated associations between malnutrition diagnoses and subsequent Covid-19 severity, using medical records for 8,604 children and 94,495 adults (older than 18 years) who were hospitalised with Covid-19 in the US between March and June 2020. Patients with a diagnosis of malnutrition between 2015 and 2019 were compared to patients without.
Of 520 (6 per cent) children with severe Covid-19, 39 (7.5 per cent) had a previous diagnosis of malnutrition, compared to 125 (1.5 per cent) of 7,959 (98.45 per cent) children with mild Covid-19. Of 11,423 (11 per cent) adults with severe Covid-19, 453 (4 per cent) had a previous diagnosis of malnutrition, compared to 1,557 (1.8 per cent) of 81,515 (98.13 per cent) adults with mild Covid-19.
New York, July 14 (IANS) A centralised repository of Covid-19 health records built by US researchers, last year, has been helpful in tracing the progression of the disease over time and could eventually be used as the basis for decision-making tools.The National Covid Cohort Collaborative (N3C) is a centralised, harmonised, high-granularity electronic health record repository that is the largest, most representative Covid-19 cohort to date.This multicenter data set can support robust evidence-based development of predictive and diagnostic tools and inform clinical care and policy, said a team of researchers from those including at Universities of Colorado, Michigan, Rochester Medical Center, and Johns Hopkins.The cohort study, published in the JAMA Network, used data from 34 medical centers and included over 1 million adults -- 174,568 who tested positive for Covid-19 and 1,133,848 who tested negative between January 2020 and December 2020."This cohort study found that Covid-19 mortality decreased over time during 2020 and that patient demographic characteristics and comorbidities were associated with higher clinical severity," said Tellen D. Bennett, from Department of Pediatrics at Colorado's School of Medicine."The machine learning models accurately predicted ultimate clinical severity using commonly collected clinical data from the first 24 hours of a hospital admission," Bennett added.The machine learning models accurately predicted clinical severity -- mortality was 11.6 per cent overall and decreased from 16.4 per cent in March to April 2020 to 8.6 per cent in September to October 2020.The most powerful predictors in the ML models are patient age and widely available vital signs and laboratory values. These models, although intended as examples of how N3C can be used, could also be the basis for generalisable clinical decision support tools, the researchers said.The N3C harmonises data from a very large number of clinical sites, which is important because significant site-level variation in critical metrics, such as invasive ventilatory support and mortality, has been reported. Expected trajectories can contribute to practitioner decision-making about what a patient will need, Bennett said.--IANSrvt/dpb
New York, July 9 (IANS) Long-term exposure to fine particulate matter (PM2.5) was associated with more than three times the odds of being ventilated and twice the likelihood of a stay in ICU due to Covid-19, finds a study.The greater the exposure, the greater the risk, revealed researchers from the Henry Ford Hospital in Detroit, US.While it is not clear how air pollutants contribute to more severe disease, it is possible that long-term exposure to air pollution may impair the immune system, leading both to increased susceptibility to viruses and to more severe viral infections, they said.Further, the fine particles in air pollution may also act as a carrier for the virus, increasing its spread."Our study calls attention to the systemic inequalities that may have led to the stark differences in Covid-19 outcomes along racial and ethnic lines," said Anita Shallal from the hospital."Communities of colour are more likely to be located in areas closer to industrial pollution, and to work in businesses that expose them to air pollution," she added.The study was conducted in Detroit -- the 12th most polluted city in the US, measured by year-round PM2.5, according to the American Lung Association.The team analysed data from 2,038 adults with Covid-19 admitted in hospitals between March 12 and April 24, 2020. Patients were followed until May 27, 2020.They found that patients who were male, black, obese, or had more severe long-term health conditions were much more likely to be mechanically ventilated and admitted to the ICU. So too were patients living in areas with higher levels of PM2.5 and lead paint."The key takeaway is that living in a more polluted neighbourhood is an independent risk factor for severity of Covid-19 disease," Shallal said."Urgent further research is needed to guide policy and environmental protection, to minimise the impact of Covid-19 in highly industrialised communities that are home to our most vulnerable residents," she noted.The study will be presented at the 2021 European Congress of Clinical Microbiology and Infectious Diseases to be held online between July 9 and 12.--IANSrvt/vd
London, July 9 (IANS) The overall risk of children becoming severely ill or dying from Covid is extremely low, a new study has confirmed.The study, led by scientists from University College London, and the Universities of York, Bristol and Liverpool, showed that the overall risk of hospitalisation and death remained low in children, the BBC reported.However, those living with multiple chronic illnesses and neuro-disabilities were most at risk, they said.The team analysed England's public health data and found that among the young people who had died of Covid-19, around 15 had life-limiting or underlying conditions, including 13 living with complex neuro-disabilities, while six had no underlying conditions recorded in the last five years.Further, 36 children had a positive Covid test at the time of their death but died from other causes, the analysis suggests. Children and young people who died were more likely to be over the age of 10 and of Black and Asian ethnicity, the BBC report said.Currently, under-18s are not routinely offered Covid vaccines, even if they have other underlying health conditions that put them at risk.The findings are being considered by the UK's vaccine advisory group, the report said.The complex decisions around vaccinating children requires in-depth research. Data expected from studies in children in the US and Israel, should also be taken into account when making the decision, lead researcher Prof Russell Viner, was quoted as saying.However, if there were adequate vaccines, their research suggested certain groups of children could benefit from receiving Covid jabs, he said."I think from our data, and in my entirely personal opinion, it would be very reasonable to vaccinate a number of groups we have studied, who don't have a particularly high risk of death, but we do know that their risk of having severe illness and coming to intensive care, while still low, is higher than the general population," Viner said."Although this data covers up to February 2021, this hasn't changed recently with the Delta variant. We hope this data will be reassuring for children and young people and their families," added Elizabeth Whittaker, from the Royal College of Paediatrics and Child Health and Imperial College London.--IANSrvt/vd
Sydney, July 3 (IANS) A team of researchers have successfully repurposed two existing medications to reduce the severity of sleep apnoea in people by at least 30 per cent.
Sleep apnoea is a condition where the upper airway from the back of the nose to the throat closes repetitively during sleep, restricting oxygen intake and causing people to wake as often as 100 times or more per hour.
Those with untreated sleep apnoea are more likely to develop cardiovascular disease, dementia and depression, and are two to four times more likely to crash a car than the general population, indicates the study published in The Journal of Physiology.
"We were thrilled because the current treatment options for people with sleep apnoea are limited and can be a painful journey for many," said researcher Danny Eckert from Flinders University in Australia.
Previous research showed two classes of medication -- reboxetine and butyl bromide -- were able to keep muscles active during sleep in people without sleep apnea and assist their ability to breathe.
By repurposing the medications, researchers used a multitude of recording instruments to measure whether reboxetine and butylbromide could successfully target the main causes of sleep apnoea.
This included balancing the electrical activity of muscles around the airway, preventing the throat from collapsing while people were sleeping, and improving the regulation of carbon dioxide and breathing during sleep.
The results from the study showed these medications did in fact increase the muscle activity around participants' airways, with the drugs reducing the severity of participants' sleep apnoea by up to one-third.
Sao Paulo, June 4 (IANS) People with dementia, particularly Alzheimer's disease are at threefold risk of dying as a result of infection by SARS-CoV-2, the virus behind Covid-19, according to a study by Brazilian researchers.The risk is six times greater if they are over 80, found the team at the University of Sao Paulo (USP) and Butantan Institute in partnership with colleagues at the Federal University of Rio de Janeiro (UFRJ)."We found that all causes of dementia are risk factors for severity and death in Covid-19and that these risks are more pronounced for Alzheimer's patients," Sergio Verjovski-Almeida, principal investigator for the project and a professor at USP's Chemistry Institute, told Agencia FAPESP."Some factor that hasn't yet been identified increases the predisposition of Alzheimer's patients to progress to severe Covid-19 and die from the viral disease," Verjovski said. "The results of our study point to a need for special attention to these patients when hospitalised."The findings are published in Alzheimer's & Dementia: The Journal of the Alzheimer's Association.For the study, the researchers investigated data on positive diagnoses, hospitalisations and deaths from Covid-19 for a cohort of 12,863 patients over 65, who tested positive or negative for Covid between March and August 2020. They were classified into three age groups: 66-74 (6,182), 75-79 (4,867), and 80-86 (1,814). Statistical analysis showed that all causes of dementia, especially Alzheimer's, were risk factors for severity of the disease and death in the case of hospitalised patients, regardless of age.A possible explanation is that chronic inflammatory conditions or defective immune responses due to ageing of the immune system (immunosenescence) may increase the vulnerability of these patients and reduce their capacity to mount an effective response to infection by the virus.Another hypothesis is that Alzheimer's alters the permeability of the blood-brain barrier, making infection of the central nervous system more likely, the researchers said.--IANSrvt/in
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