Viral load may predict ventilator need, death risk; coronavirus damages red blood cells



a man in a blue shirt: FILE PHOTO: The coronavirus disease (COVID-19) outbreak in Oldham


© Reuters/PHIL NOBLE
FILE PHOTO: The coronavirus disease (COVID-19) outbreak in Oldham

By Nancy Lapid

(Reuters) – The following is a roundup of some of the latest scientific studies on the novel coronavirus and efforts to find treatments and vaccines for COVID-19, the illness caused by the virus.

Viral load predicts need for ventilator, death risk

When COVID-19 patients are admitted to the hospital because of pneumonia, doctors can estimate their risk of needing mechanical breathing support or dying based on their “viral load” – the amount of virus genetic material obtained by swabbing the back of the nose and throat, a new study suggests. “This risk can be predicted regardless of how sick they are when they are admitted, what other comorbidities they may have, their age or how many days they had symptoms,” coauthor Dr. Ioannis Zacharioudakis of NYU School of Medicine told Reuters. His team studied 314 patients, dividing them into three groups according to viral load upon hospital admission. The group with highest viral levels had 59% higher odds of becoming critically ill or dying than the lowest viral load group. The data, published on Friday in Annals of the American Thoracic Society, “will have practical implications in our ability to judge which patients will benefit the most from early escalation of care, treatment with antivirals and/or inclusion in trials of new therapeutics,” Zacharioudakis said. (https://bit.ly/3oJijtQ)

Coronavirus damages red blood cell membranes

The new coronavirus damages the membranes of oxygen-carrying red blood cells, contributing to the hypoxemia, or low blood concentrations of oxygen, common in COVID-19, researchers have found. Signs of hypoxemia can range from shortness of breath to organ and tissue damage. Studying blood samples from COVID-19 patients and healthy individuals, researchers found the virus did not appear to affect red cells’ ability to pick up oxygen and deliver it throughout the body. But patients had “clear damage” to red cell membranes, in particular to a membrane protein responsible for helping the cell survive injuries. As a result, patients’ red cells might be more vulnerable to so-called oxidative stress and other injury, coauthor Angelo D’Alessandro of the University of Colorado Denver said in an email. Red cells circulate for up to 120 days before the body replaces them with new ones, and they cannot synthesize new components to replace the damaged parts. This might help explain why some COVID-19 symptoms can last for months, D’Alessandro said. (https://bit.ly/3mMBq4A)

Pandemic exacts toll on ER doctors’ mental health

COVID-19 is taking a toll on emergency physicians’ mental health and many are reluctant to seek help, according to poll results reported at the American College of Emergency Physicians (ACEP) annual meeting. Among a nationally representative group of 862 U.S. emergency physicians, 87% reported feeling more stressed since the pandemic began and 72% reported more burnout. More than 80% cited concern for their own health and safety, and the safety of their family and friends, around contracting COVID-19. Nearly half said they are uncomfortable seeking mental health services, 73% said

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Fitness tracker and smartwatch data used to predict COVID-19 cases

A preliminary study, from a large and ongoing research project, is suggesting measurements from fitness tracker wearables and smartwatches, alongside self-reported symptom data, can effectively detect cases of COVID-19. The goal of the project is to develop a real-time tracking system that can help identify and contain viral outbreaks at their earliest point.

“One of the greatest challenges in stopping COVID-19 from spreading is the ability to quickly identify, trace and isolate infected individuals,” explains Giorgio Quer, first author on the new study. “Early identification of those who are pre-symptomatic or even asymptomatic would be especially valuable, as people may potentially be even more infectious during this period. That’s the ultimate goal.”

Researchers from Scripps Research Translational Institute have previously demonstrated how influenza outbreaks can be tracked using wearable fitness devices such as a Fitbit. Early in 2020 the researchers launched a new study called DETECT (Digital Engagement and Tracking for Early Control & Treatment), which called for the general public to sign up to a research app that collects fitness tracker data and logs self-reported symptoms. By June over 30,000 subjects had signed on to the project.

A newly published study in the journal Nature Medicine is reporting the first results from DETECT, revealing fitness wearable data, along with self-reporting of symptoms, can detect cases of COVID-19 with around 80-percent accuracy. This predictive rate is significantly higher than models based on self-reported symptoms alone.

“This is really an exciting result,” says Eric Topol, Director of Scripps Research. “It shows that passive, continuous monitoring, with devices like Fitbit and the Apple Watch might turn out to be an important public health surveillance tool for COVID-19. Especially in a time when we don’t have enough tests or at enough frequency with enough turnaround of results, this might be a way to identify and isolate the individuals who are infected.”

Heart rate, sleep, and activity data were the key wearable measurements that proved most helpful in detecting COVID-19 cases. While everyone’s individual baseline measurements were slightly different, by evaluating deviations from normal measurements over time the researchers were able to effectively detect cases of COVID-19.

The predictive model being developed through the DETECT study still needs more work before it can be deployed in the real-world so Jennifer Radin, a Scripps epidemiologist leading the study, is calling for citizen scientists to download the free app and anonymously offer their wearable data to help accelerate the research project.

“We’re just getting started with DETECT,” says Radin. “We have so much more research to do and that’s going to require many more participants. I’d love for us to have 100,000 or more people. That would give us the data we need to take this to the next level.”

If you are interested in helping out with the project, more information can be found at Detect Heath Study.

The new study was published in the journal Nature Medicine.

Source: Scripps Research

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Ask the Doctors: Studies show fitness trackers can predict illness | Health

Dear Doctors: My husband caught a cold this summer, and he swears the readings from his fitness tracker a few days before warned him that he was about to be sick. Do you think that’s really possible?

Dear Reader: Your husband’s observations about how changes in the data from his fitness tracker preceded the onset of a cold actually dovetail with the findings of a study that were published at the start of the year. And it’s not the first research of its kind to make the connection. With millions of people now using fitness trackers, scientists are diving into the trove of uploaded data to see what the details may be able to reveal about public health.

For anyone unfamiliar with fitness trackers, they’re wearable sensors, much like a wristwatch, that measure a range of activity and health metrics. Depending on the device — there are dozens of different brands and types — fitness trackers measure steps taken, total mileage, speed, direction, elevation climbed and duration of activity. On the physiological side of things, they can track heart rate, heart rhythms, skin temperature and minutes of sleep. Some manufacturers even claim that, using motion sensors and algorithms, their models can map how long someone spends in the various stages of sleep. (Full disclosure: Many sleep specialists are skeptical about the accuracy of the sleep-stage results.)

In a recent study, researchers from the Scripps Research Translational Institute analyzed data collected from the fitness trackers of 47,000 adult women and men. Using a minimum of two months’ worth of readings taken over the course of two years, which included activity, heart rate and sleep, the researchers found that their predictions of regional flu outbreaks matched the statistical data collected by the Centers for Disease Control and Prevention during those same time periods. An earlier study, published by researchers at Stanford University in early 2017, had come to similar conclusions. In that study, the scientists collected 250,000 daily readings from just 43 individuals over the course of a year. The participants wore a range of biosensors, which collected information about daily activity, heart rate, oxygen saturation levels, skin temperature and sleep data. They even tracked exposure to radiation, such as the X-rays and gamma rays encountered in air travel.

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Early results from DETECT study suggest fitness trackers can predict COVID-19 infections

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IMAGE: The DETECT study uses a mobile app to collect smartwatch and activity tracker data from consenting participants, and also gathers their self-reported symptoms and diagnostic test results. Any adult living…
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Credit: Scripps Research

LA JOLLA, CA–Examining data from the first six weeks of their landmark DETECT study, a team of scientists from the Scripps Research Translational Institute sees encouraging signs that wearable fitness devices can improve public health efforts to control COVID-19.

The DETECT study, launched on March 25, uses a mobile app to collect smartwatch and activity tracker data from consenting participants, and also gathers their self-reported symptoms and diagnostic test results. Any adult living in the United States is eligible to participate in the study by downloading the research app, MyDataHelps.

In a study that appears today in Nature Medicine, the Scripps Research team reports that wearable devices like Fitbit are capable of identifying cases of COVID-19 by evaluating changes in heart rate, sleep and activity levels, along with self-reported symptom data–and can identify cases with greater success than looking at symptoms alone.

“What’s exciting here is that we now have a validated digital signal for COVID-19. The next step is to use this to prevent emerging outbreaks from spreading,” says Eric Topol, MD, director and founder of the Scripps Research Translational Institute and executive vice president of Scripps Research. “Roughly 100 million Americans already have a wearable tracker or smartwatch and can help us; all we need is a tiny fraction of them–just 1 percent or 2 percent–to use the app.”

With data from the app, researchers can see when participants fall out of their normal range for sleep, activity level or resting heart rate; deviations from individual norms are a sign of viral illness or infection.

But how do they know if the illness causing those changes is COVID-19? To answer that question, the team reviewed data from those who reported developing symptoms and were tested for the novel coronavirus. Knowing the test results enabled them to pinpoint specific changes indicative of COVID-19 versus other illnesses.

“One of the greatest challenges in stopping COVID-19 from spreading is the ability to quickly identify, trace and isolate infected individuals,” says Giorgio Quer, PhD, director of artificial intelligence at Scripps Research Translational Institute and first author of the study. “Early identification of those who are pre-symptomatic or even asymptomatic would be especially valuable, as people may potentially be even more infectious during this period. That’s the ultimate goal.”

For the study, the team used health data from fitness wearables and other devices to identify–with roughly 80% prediction accuracy–whether a person who reported symptoms was likely to have COVID-19. This is a significant improvement from other models that only evaluated self-reported symptoms.

As of June 7, 30,529 individuals had enrolled in the study, with representation from every U.S. state. Of these, 3,811 reported symptoms, 54 tested positive for the coronavirus and 279 tested negative. More sleep and less activity than an individual’s normal levels were significant

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Having more than 5 coronavirus symptoms may predict long-COVID case

  • Patients who experience more than five COVID-19 symptoms during their first week of illness are more likely to have a long-term case, according to a new study.
  • Certain symptoms in particular — fatigue, headache, difficulty breathing, a hoarse voice, and muscle or body aches — were also found to be early signs that a patient might not recover quickly.
  • Age, gender, and BMI could play a role as well, according to the study.
  • Visit Business Insider’s homepage for more stories.

For a select group of coronavirus patients known as “long-haulers,” the onset of symptoms is the beginning of an extended battle. Many COVID-19 patients develop weeks- or months-long illnesses that researchers now call “long-COVID.”  

These individuals are difficult to study, since not all received a proper diagnosis initially due to testing shortages or the abnormal nature of their symptoms. Some may simply not report lingering ailments, making them difficult for researchers to track.

But a spate of preliminary studies are beginning to pinpoint the early signs that a patient won’t recover right away.

A recent study from King’s College London, which is still awaiting peer review, examined more than 4,000 coronavirus patients across Sweden, the UK, and the US by asking them to record their symptoms in an app. About 20% said they still weren’t feeling better after four weeks — the threshold at which the researchers mark a case of long-COVID. By eight weeks, around 190 patients reported lingering symptoms. And by 12 weeks, nearly 100 patients said they hadn’t recovered yet.

Patients who experienced more than five symptoms during the first week of their illness were significantly more likely to develop long-COVID, the study found. That was true across sex and age groups.

The researchers also identified five symptoms that predicted a case of long-COVID more than others: fatigue, headache, difficulty breathing, a hoarse voice, and muscle or body aches. This could offer clues about targets for future COVID-19 treatments.

“It’s important we use the knowledge we have gained from the first wave in the pandemic to reduce the long-term impact of the second,” Dr. Claire Steves, the study’s senior author, said in a statement. “Thanks to the diligent logging of our contributors so far, this research could already pave the way for preventative and treatment strategies for long-COVID.”

Nearly 98% of patients with long-COVID in the study reported fatigue, while 91% reported a headache.  

“We know that fatigue is a huge component, so I’m really glad that their research captured that,” Natalie Lambert, an associate professor of medicine at Indiana University who wasn’t involved in the study, told Business Insider.

Lambert is also looking at patterns of symptoms among long-COVID patients. All of the roughly 1,500 long-haulers she surveyed in July said they’d experienced fatigue at some point in their illness. Roughly two-thirds said they had experienced muscle or body aches. The same amount said they had difficulty breathing, and around 58% said they had developed a headache.

The results of the King’s College study, Lambert said,

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UK to carry out a million COVID tests a day by Christmas, scientists predict

A member of staff collects a completed test kit from a visitor at a Covid-19 testing centre in Southwark, south London, after a range of new restrictions to combat the rise in coronavirus cases came into place in England. (Photo by Dominic Lipinski/PA Images via Getty Images)
A member of staff collects a completed test kit in Southwark, south London (Picture: Getty)

The UK will carry out a million COVID-19 tests a day by Christmas with results being given in as little as 15 minutes, scientists have predicted. 

The government has already set a target of 500,000 tests a day by the end of October but this could be doubled by the end of the year, according to a report in the Times. 

The newspaper quoted an unnamed senior scientist who claimed it seemed “perfectly possible” the country could reach a million tests by the festive period.

The source said: “It’s going pretty well.  They have really scaled up their capabilities.

“By Christmas we’ll be at a million a day, I think. That seems perfectly possible.”

Watch: PM hopes to resist national lockdown

Boris Johnson announced on Friday the UK is developing the capacity to manufacture millions of fast turnaround tests for coronavirus which could deliver results in just 15 minutes.

The prime minister told a No 10 press conference the new tests were “faster, simpler and cheaper” and that work was being done to ensure they could be manufactured and distributed in the UK.

He said: “We’ve already bought millions of these tests, some of which are very simple, meaning you simply need to wipe the swab inside your mouth and can give a result as quickly as in 15 minutes.”

“We’ve started building the infrastructure for domestic manufacture of these tests, ensuring that Britain has the ability to produce millions of fast tests here.

“Over the next few weeks we will start distributing and trialling these tests across the country.”

Andrew Ilesley gets his QR code scanned using a smart phone to demonstrate how to use the new walk-through Covid testing centre in Dundee. The test centre uses a system of connected trailers cleaned using dry ice, the first site in Scotland to have this capability. (Photo by Jane Barlow/PA Images via Getty Images)
A COVID-19 testing centre in Dundee (Picture: Getty)

Downing Street has also announced further pilots of new testing technologies will begin from next week, across some of the UK’s worst-affected regions.

The government said that hospitals in Manchester, Liverpool, Birmingham, Leeds, Newcastle, Basingstoke and Southampton will test asymptomatic NHS staff, and use the data to assist with Track and Trace.

These pilots will see individuals tested weekly as a minimum.

In addition, trials of new “lateral flow tests” – swab tests that do not require lab processing and can be returned within an hour – would be sent to adult social care settings, schools and universities in the hardest-hit areas.

Johnson said that Liverpool, Lancashire, and any other areas which enter the “very high” alert level would be “immediately prioritised” for fast turnaround tests.

The government will also make tests available to local public health directors to help control localised outbreaks.

Johnson added: “In time we want to use tests to keep open more parts of the economy that have sadly been closed but it is crucial that we make sure such systems work safely,

“I must level with you that it will take time to get this right before many organisations can buy and operate these tests themselves.”

Watch: Can you catch the coronavirus twice?

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