This is the reason why covid-19 pneumonia lasts longer and is more severe than typical

R. Ibarra

Updated:

save

The bacteria or viruses like the flu that cause pneumonia can spread over large areas of the lung over the course of hours. In an intensive care unit (ICU), these bacteria or viruses are controlled by antibiotics or by the immune system during the first days of the illness.

But according to a study published in “Nature”, COVID-19 pneumonia is different.

Rather than rapidly infecting large regions of the lung, the virus that causes COVID-19 settles in multiple small areas of the lung. It then hijacks the lungs’ own immune cells and uses them to spread through the lung for an extended period of time, days or even weeks, like multiple wildfires raging through a forest. And, as the infection moves slowly through the lung, it leaves damage in its wake and continually fuels fever, and damage to the kidneys, brain, heart, and other organs.

“It is a totally different mechanism,” says Germán Peces Barba, from the Jiménez Díaz Foundation University Hospital and group leader at CIBERES.

As the infection moves slowly through the lung, it leaves damage in its wake and continually fuels fever, and damage to the kidneys, brain, heart, and other organs.

“In a sibylline way -says the pulmonologist Rosario Menéndez- it creates foci in the lung that, little by little they are distributed and causing the injury”. This expert from the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) explains that this dissemination of foci produces a «amplifying effect of the inflammatory response that can sometimes lead to so-called respiratory distress which, in the worst case, will require oxygen and mechanical ventilation».

And this ‘different’ mechanism of action, adds Peces Barba, means that this entity has a different prognosis and that some drugs will not work. But, curiously, says Peces Barba, “the mortality of cases of pneumonia due to covid-19 is lower than that of conventional pneumonia.”

Thus, the study shows that mortality among patients on mechanical ventilation due to Covid-19 was lower than that of ventilated patients with regular pneumonia. “People with covid-19 pneumonia are sick for a long time, but the inflammation of the lungs is not as severe as normal pneumonia.”

Mortality in covid-19 pneumonia cases is lower than that of conventional pneumonia

The severe complications of COVID-19 compared to other pneumonias could be related to the prolonged course of the disease rather than a more serious illness, the study authors say.

The study is very relevant, highlights Dr. Menéndez, a pulmonologist at Hospital La Fe (Valencia), because it is one of the first in which the immune cells of the lungs of patients with COVID-19 pneumonia have been systematically obtained from through bronchoalvelar lavage and compared with cells from patients with pneumonia from other viruses or bacteria.

Specifically, he explains, “they have seen that macrophages – cells of the immune system – are not capable of fighting the virus that uses these cells to live inside and uses it as a ‘trojan‘”. In this way, “the virus spreads throughout the lung generating different foci, visible through imaging tests.”

The data from this work, says the SEPAR pulmonologist, supports the hypothesis that the inflammation and damage persists longer than conventional pneumonia. And that damage, he warns «affects other organs, such as the endothelium -inner layer of blood vessels- and endothelitis -inflammation of the endothelium-, would explain the long-term damage of the disease».

An added problem, the CIBERES pulmonologist points out, is that «we do not have early detection systems or markers to determine which patients with pneumonia are going to get worse, there is no common pattern, and in a few hours they can be complicated.

Fortunately, there are treatments, Menendez points out, “because we have learned over time what works – corticosteroids, remdesivir … – and what does not work – antivirals, hydroxychloroquine … -“. But, he stresses, “we would like to have more antivirals. We have more antibacterials than antivirals.

Researchers have also identified critical new targets for treating severe SARS-CoV-2 pneumonia and reducing its damage: macrophages and T cellsOur goal is to make covid-19 a mild illness, comparable to a bad cold

In the study of «Nature»Researchers have also identified critical new targets for treating severe SARS-CoV-2 pneumonia and reducing its harm. These targets, they write, would be immune cells: macrophages and T cells.We have seen that macrophages, cells in charge of protecting the lung, can become infected with SARS-CoV-2 and help spread the infection through the lung».

For this reason, researchers at Northwestern Medicine University (USA) are testing an experimental drug targeting these targets in patients with COVID-19 pneumonia in an ongoing clinical trial. “The drug inactivates the inflammatory response of these immune cells, which allows the start of the repair process in the injured lung,” they detail in their article.

“Our goal is to turn COVID-19 into a mild illness, comparable to a severe cold,” says study co-author Scott Budinger.

The information in this work is relevant because, according to this team, «this rapidly mutating RNA virus will elude current vaccines», Hence the importance of developing treatments to reduce the severity of covid-19 in those who develop it

See them
comments

.

Pfizer is supplying less vaccine to Europe for the time being – the head of the chancellery expects an effort by the summer

Spain has for the first time since the beginning of the corona pandemic more than 40,000 new infections reported within one day. The number of infections rose by 40,197 to a total of more than 2.25 million, the Ministry of Health announced in Madrid on Friday. The previous high was reached on Wednesday with 38,869. Because the numbers have been increasing for weeks, several regions, including Madrid, decided on one Tightening of measures to contain the pandemic.

The nocturnal Going lock the regional government announced on Friday that it will be brought forward by one hour to 11 p.m. in the capital region from Monday. Restaurants, cafés and bars in the entire so-called autonomous community will then have to close at 10 p.m. – instead of at midnight as before. According to the information, the tightening of the measures will initially apply for two weeks.

In addition, the number the one in Madrid cordoned off areasthat can only be left or entered with valid reason, in a total of 19 municipalities and 47 smaller districts elevated. A total of 1.3 million of the 6.7 million inhabitants in the region are affected.

.

+++ Corona-News +++: Merkel allegedly wants to bring forward the federal-state round and tighten lockdown

Federal government extends application deadline for corona aid +++ France tightened curfew +++ Study: infected people probably protected from re-infection for five months +++ The news blog. .

Merkel supposedly wants to bring forward the federal-state round and tighten lockdown – extended application deadlines for aid

After surviving a corona infection According to a study, people are very likely Protected from re-infection for at least five months. However, there is Hints, that too People with antibodies the Spread virus could, it said in the study by the health authority Public Health England (PHE) among employees of the British health system. However, the study cannot make any statements about the effects of vaccines at this point in time. “We now know that most of those who had the virus and developed antibodies are protected from re-infection,” said Susan Hopkins, senior medical advisor to the agency and co-lead on the study, but this protection is not complete. It is also unclear how long this will last. After surviving an infection, a severe Covid 19 disease is highly unlikely. But there is still the risk of getting infected and infecting others.

Participated in the study so far Tens of thousands of UK healthcare workers part. They have been tested regularly for both corona infection and antibodies since June. Of the 6,614 participants who tested positive for antibodies, there were only 44 possible new infections, according to the study.

Experts who were not involved in the study spoke of important findings. “These data reinforce the message that for the time being everyone is a potential source of infection for others and should act accordingly,” said Eleanor Riley, Professor of Immunology and Infectious Diseases at Edinburgh University. Simon Clark of Reading University said: “This means that the vast majority of the population must either have natural immunity or have been vaccinated in order for us to completely lift the restrictions in our lives. Unless we’re prepared for many more people to be infected and die from Covid-19. “

.

+++ Corona-News +++: Bavaria wants to promote home office taxation – Biontech vaccine will soon also be produced in NRW

Spahn: “We have been in a permanent exceptional situation for months” +++ US epidemic authorities have administered around 10.3 million vaccine doses so far. +++ The news blog. .

The greatest danger is that a variant is generated that escapes vaccines

R. Ibarra

Madrid

Updated:

save

First it was the UK, then South Africa and now the US and Japan. The variants of the SARS-CoV-2 coronavirus seem to have a greater transmission capacity, although not a greater lethality, and could lead to a new scenario in this pandemic that has plagued the planet for a year now

As at the beginning of 2020, scientists are trying to analyze what the appearance of these new variants means for the control of the pandemic, especially now that there are already vaccines available for covid-19.

The appearance of variants, such as that of the United Kingdom, explains Isabel Sola, from the CSIC’s National Center for Biotechnology, “means that there has been some kind of selective pressure on the virus that has forced it to mutate and change.” Alone, one of the people in Spain who knows the most about coronavirus and who together with Luis Enjuanes works on the development of a vaccine against covid-19, explains that for a virus to evolve there must be something of an “advantage” and make it “more competent against other viruses». In the end, he says “the variant with the most advantages will prevail.”

But those changes, he warns, do not make that variant per se more lethal or transmissible, or compromise the efficacy of existing vaccines. «The relevance of these variations remains to be determined. They don’t mean anything until we have more information, ”he says.

«Come on virus ARN [como el coronavirus] they mutate a lot, there are already more than 100 variants identified from SARS-CoV-2 ”, explains Alberto Delgado-Iribarren, head of the Microbiology Service of the San Carlos Clinical Hospital in Madrid. But if there are no conformational changes in protein S [espícula], vaccines will continue to be effective. ‘

The relevance of these variations remains to be determined. They mean nothing until we have more information

“The greatest danger is that a variant is generated that escapes the vaccines,” says María Tomas, Microbiologist at the Hospital de A Coruña, and spokesperson for the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC).

For now, the changes that these variants carry do not compromise the efficacy of the vaccines. “The approved vaccines, and available in Spain, generate polyclonal antibodies, that is, they are directed towards a wide spectrum of protein S”.

Thus, a study still in prepublication confirms that the immune responses induced by the Pfizer-BioNTech vaccine are effective in neutralizing the SARS-CoV-2 mutant N501Y, the mutation shared by the variants that emerged in the United Kingdom and South Africa. «The message of this article is that vaccines could be effective against these variants», Says María Tomas.

“At the moment there is no need to be alarmed,” says Delgado Iribarren, who does not rule out that within a few years, it is possible that a variant will appear “that escapes vaccines; but we don’t know that ».

The approved vaccines, and available already in Spain, generate polyclonal antibodies, that is, they are directed towards a wide spectrum of protein S

And if that happened, it wouldn’t be such a worrying situation either, says Isabel Sola. «The technology with which RNA vaccines for coronavirus have been designed allow for easy reformulation». It is the great advantage of this technology, says Delgado Iribarren, and “it will allow us a much quicker response if, in the end, such an elusive variant arises.”

However, some countries, alarmed by the new variants, have accelerated the vaccine authorization processes. But, as the new variant appears in other countries, or others emerge elsewhere such as the US or Japan, many scientists are asking governments to strengthen existing control measures as well.

When British Prime Minister Boris Johnson announced tough new restrictions on January 4, including school closings, he demanded that citizens not leave their homes unless strictly necessary. But, until that date, the United Kingdom, for example, did not force the use of a mask abroad and neither did children.

The human factor in the spread of the coronavirus is decisive. A virus is how it is and what its host is like

“We cannot put all the blame on the virus,” acknowledges the CNB expert. «The human factor in the spread of the coronavirus is decisive. A virus is how it is and what its host is like ”, he says.

María Tomas stresses this line: “It is possible that the measures have not been restrictive enough and may have favored the appearance of these new variants.” And he underlines, «until there is a percentage of 60-70% of the vaccinated population, we must continue to be very responsible. Even today, many people still take the infection as mild. Many of the things that are still being done today favor the spread of the virus, “he denounces.

In Spain, without a British variant, we are already in the third wave; yes, with the sea in the background

In announcing the UK restrictions, Johnson said the new variant was 50-70% more transmittable. But many researchers have noted that this is a scientifically unproven claim.

While it is true that cases have skyrocketed in the UK over the past month, and also in South Africa, the spike came while different parts of the country had varying levels of restrictions and amid changes in behavior in the prior period to Christmas. “A complex scenario that favors the spread of the virus,” says Delgado Iribarren.

In any case, the microbiologist adds, “in Spain, without a British variant, we are already in the third wave; yes, with the sea in the background ».

See them
comments

.

Netherlands extend lockdown – From Friday registration is mandatory when entering Austria

Three Democratic MPs of the US House of Representatives tested positive for the coronavirus after the siege of the Capitol building by Trump supporters been. MP Brad Schneider said he received a positive test result on Tuesday. The Democrats Pramila Jayapal and Bonnie Watson Coleman had previously made their infection public. The Democrats accused Republican MPs of not wanting to wear a mask when they were offered one.

“Too many Republicans have refused to take this pandemic and virus seriously, putting everyone around them at risk,” Jayapal said. “Just hours after President Trump instigated a deadly attack on our Capitol, our country and our democracy, many Republicans still refused to take the bare minimum of Covid-19 precaution and simply put a damn mask in a crowded room during a pandemic to wear. ”Schneider accused the mask refusers with selfishness and arrogance.

Coleman, Schneider and Jayapal were among dozens of MPs who had been moved to a safe location during the uprising. Several members of Congress spent hours in the great room. Congressional doctor Brian Monahan urged all MPs to get tested for the coronavirus because they may have been exposed to the virus.

.

Netherlands want to extend lockdown – Merkel criticizes implementation of corona protection in old people’s homes

Three Democratic MPs of the US House of Representatives Tested positive for the corona virus after the siege of the Capitol building by Trump supporters been. MP Brad Schneider said he received a positive test result on Tuesday. The Democrats Pramila Jayapal and Bonnie Watson Coleman had previously made their infection public. The Democrats accused Republican MPs of not wanting to wear a mask when they were offered one.

“Too many Republicans have refused to take this pandemic and virus seriously, putting everyone around them at risk,” said Jayapal. “Just hours after President Trump instigated a deadly attack on our Capitol, our country and our democracy, many Republicans still refused to take the bare minimum of Covid-19 precaution and simply put a damn mask in a crowded room during a pandemic to wear. ”Schneider accused the mask refusers with selfishness and arrogance.

Coleman, Schneider and Jayapal were among dozens of MPs who had been moved to a safe location during the uprising. Several members of Congress spent hours in the great room. Congressional doctor Brian Monahan urged all MPs to get tested for the coronavirus because they may have been exposed to the virus.

.

British are increasing the vaccination rate – Spahn expects herd immunity in summer

In the fight against the high number of corona cases, the UK government increase the pace of vaccination. So far, about 2.6 million vaccine doses have been administered, Health Secretary Matt Hancock said on Monday. At the same time, he warned against neglecting the measures to contain the virus. The new virus variant was “highly contagious” and put the NHS health service under “considerable pressure”, said the minister.

Prime Minister Boris Johnson had also called for increased vigilance, otherwise the lockdown measures would have to be stepped up. “Now is the time to be extremely vigilant, to comply with the rules,” said Johnson while visiting a vaccination center in Bristol.

As many first vaccinations as possible are given in the UK, the second dose is expected to follow within twelve weeks. To date, just over 370,000 people have received a second dose.

With around 46,000 new infections, the number of new infections reported in Great Britain on Monday was slightly lower than last week. But the number of Covid-19 patients who have to be treated in hospital continues to rise.

.

Is it safe to fly in times of covid-19?

R. Ibarra

Madrid

Updated:

save

Is it safe to fly in times of covid-19? Air filtration systems in airplanes are assumed to reduce the risk of infection among passengers, even when one or more infected persons are on the flight. Airlines have updated and adjusted their requirements for travelers, with mixed results: some work to maintain social distance, but others are less attentive.

Sometimes the use of masks depends on passenger compliance and is not predictable; nor, increasingly, the flight capacity, which can oscillate between 20 percent, but there are flights that go almost complete.

That leaves millions of airline passengers experiencing first-hand the uncertainties that come with flying during a pandemic.

Due to multiple variables, infectious disease specialists have had a difficult time determining the risks of flying. But a study published this week in “Emerging Infectious Diseases” sheds some light.

The study details the events that occurred on an 18-hour flight, from Dubai is Auckland (New Zealand), last September, which was the origin of an outbreak that probably occurred during the trip.

The plane, a Boeing 77, with a capacity of almost 400 passengers, had an occupancy of 25%

The researchers, using seat plans and genetic analysis, determined that one passenger started a chain of infection that spread to four others during the journey.

The analysis, led by researchers from the New Zealand Ministry of Health, found that seven of the 86 passengers on board tested positive during their quarantine and that at least four were infected on the flight. The plane, a Boeing 77, with a capacity of almost 400 passengers, had a 25% occupancy.

Airport
Airport – Archico

These seven passengers came from five countries. Two acknowledged that they did not wear masks and that the airline did not require them to wear them in the lobby before boarding. It also did not require pre-flight testing, although five of the seven passengers who later tested positive had undergone a test and received a negative result in the days leading up to boarding.

The versions of the coronavirus carried by all seven were practically genetically identical, suggesting that one of them started the outbreak. That person, whom the report calls Passenger A, had in fact tested negative four or five days prior to boarding.

Evidence of transmission on that flight is supported by epidemiological data, symptom onset dates, and genomic data from this group of travelers who tested positive for SARS-CoV-2.

Of the 7 passengers, two (A and B) were probably the index cases – and were infected before the flight, four (C, D, E, and F) were probably infected during the flight, and the remaining passenger (G) was infected while in quarantine. “The 7 passengers were located in aisle seats 2 rows away from where the alleged index cases were sitting,” they write in their article.

Researchers from the New Zealand Ministry of Health claim that «These data present a probable scenario of more than 4 SARS-CoV-2 transmission events during a long-haul flight from Dubai to Auckland. And this transmission occurred despite the use of masks and gloves».

The 7 passengers were located in aisle seats 2 rows away from where the alleged index cases were seated

These conclusions are supported by genome sequencing, an on-board seating chart and disease onset dates, they write.

However, they acknowledge that this data does not totally exclude an alternative exposure event, such as virus transmission at Dubai airport prior to boarding (for example, during check-in or in boarding queues). However, “the proximity of the relevant passengers on board suggests that in-flight transmission is plausible,” they conclude.

And, because similar reports of SARS-CoV-2 transmission during flight have been released recently, experts note that the information demonstrates the potential for SARS-CoV-2 to spread on long-haul flights.

In addition, the report warns of another very relevant event. “The fact that 3 passengers tested positive for COVID-19 on the third day of their 14-day quarantine period indicates some of the complexities of determining the value of pre-departure tests, including type and timing. of said tests ”.

Network of probable transmission of coronavirus 2. The area in gray illustrates the probable transmission of the virus in flight.  Dotted circles represent probable virus transmission between fellow travelers.
Network of probable transmission of coronavirus 2. The area in gray illustrates the probable transmission of the virus in flight. Dotted circles represent probable virus transmission between fellow travelers. – EID

The results are very relevant because, unlike other previously reported works, when few travelers wore masks, the planes were operating almost at their full capacity and the value of preventive measures had not been assumed, the new report, of a flight in largely empty, detailing what can happen even when airlines and passengers are aware and more cautious of the risks.

The findings are not definitive, cautioned the authors, led by Dr. Tara Swadi. But the results «underscore the value of considering all international passengers arriving in New Zealand as potentially infected, even if pre-departure testing was done, social distancing was maintained and personal protective equipment was used during the flight», They conclude.

See them
comments

.