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School Children Unlikely to Play a Significant Role in COVID-19 Spread

AHA Publisher — Mon, 03 Aug 2020 07:00:29 +0000

Sally Robertson, B.Sc. via News-Medical Net – A study conducted by researchers in Finland suggests that children who are exposed to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in schools are unlikely to transmit the virus further and play any significant role in the spread of coronavirus disease 2019 (COVID-19). The team’s study of exposure incidents in two different schools in Helsinki found that exposure to a 12-year-old index case did not lead to further SARS-CoV-2 transmission. In contrast, exposure to an index case, which was a staff member, did lead to further transmission. Following exposure to the adult case, the incidence of COVID-19 among children was still low, as was transmission to their household contacts. “It is likely that transmission from children to adults is limited,” writes Timothee Dub (Finnish Institute for Health and Welfare) and colleagues. The researchers say they hope the findings will help inform the prioritization of mitigation measures and reassure parents of school-aged children who are worried about the new school year starting in Autumn. A pre-print version of the paper is available on the server medRxiv*, while the article undergoes peer review. Children Were Initially Assumed to Play a Significant Role in Transmission Since the COVID-19 outbreak began in Wuhan, China, late last year, the role children play in the transmission of SARS-CoV-2 has been unclear. As the outbreak developed into a pandemic, some studies showed that children appeared to be at low risk of severe disease or death. Still, it was assumed that children might play a significant role in the transmission, and in many countries governments ordered school closures as a control measure. Schools closed in Finland on March 18th, but, at the time, very few school-related cases of COVID-19 had been reported, and the potential risk of transmission in schools was unknown. Schools were reopened again on May 14th. Early reports on school exposure where the index case was a child generated conflicting results. In France, for example, one study found that of 54 school contacts, no further transmission occurred, while another study reported a 9% attack rate, where almost half of the children were asymptomatic. Calculating Attack Rates and Identifying Transmission Chains Now, Dub and the team have conducted two retrospective cohort studies of school exposure incidents in Helsinki to assess transmission among pupils, staff, and any household contacts. “We recruited close school contacts and families of school cases, calculated attack rates (AR) on school level and families, and identified transmission chains,” writes the team. A case was defined as a person exposed at school who was positive for SARS-CoV-2 based on either reverse transcriptase-polymerase chain reaction testing or microneutralization testing. The first exposure incident (school A) involved a 12-year old index case who had been diagnosed with COVID-19, following the onset of symptoms in late February while the pupil was still attending school. Dub and colleagues identified 121 close school and sports contacts, all of whom were instructed to stay at home for 14 days. The second exposure incident (school B) involved a middle-aged staff member diagnosed with COVID-19 who had attended school for two days while experiencing symptoms, before then deciding to self-isolate. Contact tracing identified 63 exposed pupils and staff members, all of whom were told to stay at home for 14 days. Transmission Did Not Occur in School A But Did in School B In the case of school A, among 89 (74%) of the 121 close contacts who participated in the study, no further transmission was identified. In the case of school B, among 51 (81%) of 63 close contacts participating in the study, the attack rate was 16%; eight individuals were found to have COVID-19, including one member of staff. Among close household contacts of pupils who became cases, the attack rate was 31% (5 of 16), although the researchers say other plausible sources of infection were reported. “Here, we found that an adult index case could lead to further transmission among children,” say the researchers. “Age might have a role in susceptibility to SARS-CoV-2 infection in children.” However, the incidence of COVID-19 infections among children following school-related exposure was limited, as was secondary transmission among their households, says the team. The Researchers Hope the Findings Will Reassure Parents, But Say Further Research Is Needed “We hope our findings will help prioritize mitigation measures as well as reduce worry among parents of school-aged children as most EU countries are preparing for the start of a new school year in autumn,” writes the team. The researchers say further studies on COVID-19 transmission in the school setting are needed to improve recommendations for mitigation measures such as quarantine and school closures. “Starting from August 2020, the Finnish Institute for Health and Welfare will be coordinating multisite transmission studies in the five university hospital cities to understand further the role of children in SARS-CoV2 transmission chains and the role of immunity and other factors in this process,” said Dub and colleagues. To read the original article click here.

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Does Blood Plasma from COVID-19 Survivors Help Patients Infected with Novel Coronavirus?

AHA Publisher — Sat, 11 Jul 2020 07:00:30 +0000

University of California San Diego Health via Newswise – A new clinical trial at UC San Diego Health will investigate whether an old therapy might effectively treat a modern-day scourge. There is only one approved, specific treatment for COVID-19, the illness caused by the novel coronavirus SARS-CoV-2, albeit with modest efficacy. Numerous experimental or repurposed drugs are under investigation, including the arthritis drug tocilizumab. And one treatment that is more than a century old. Researchers at University of California San Diego School of Medicine and UC San Diego Health have launched a clinical trial to assess the safety and efficacy of convalescent plasma (CP) to prevent COVID-19 after a known exposure to the virus. CP therapy involves infusing patients with antibodies extracted from the blood of donors who have successfully recovered from COVID-19, with the hope that the resulting boost to their immune systems will shorten the length and reduce the severity of the disease. The UC San Diego trial is part of a larger, national effort approved by the U.S. Food and Drug Administration. The goal is to create a network of hospitals and blood banks collecting, isolating, processing and testing whether plasma from COVID-19 survivors has therapeutic, preventive value. The national trial is being coordinated by Johns Hopkins University and sponsored by the National Insitute of Health through the Department of Defense. “With convalescent plasma therapy, we want to act prophylactically, using a product with known high-titers (concentrations) of neutralizing antibodies,” said Edward Cachay, MD, an infectious disease specialist at UC San Diego Health and professor of medicine at UC San Diego School of Medicine. “We want to learn how we can prevent sickness, how we can prevent COVID patients from needed mechanical ventilation, and how we can prevent them from dying from the disease.” Before the emergence of antibiotics, CP was used to prevent and treat a host of bacterial and viral infections, including diphtheria, scarlet fever and pertussis. It was used during the 1918 influenza pandemic with reported good effect. In general, CP treatment has proven safe, but its effectiveness has varied with disease and among individuals. Studies of CP therapies for Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS) and the 2009 H1N1 influenza showed measurable reductions of mortality (compared to placebo or no therapy), but efforts to treat Ebola virus infections during the 2014-16 outbreak in West Africa were inconclusive. Chinese researchers treating COVID-19 patients have reported some success using CP, albeit not in randomized, controlled studies — the gold standard in clinical research. On April 13, the Food and Drug Administration (FDA) issued research guidelines for assessing CP as a potential COVID-19 treatment and the American Red Cross is currently seeking blood plasma donors who have fully recovered from novel coronavirus infections. Plasma is the liquid portion of blood that carries blood components throughout the body, such as red and white blood cells, platelets, salts and enzymes. It also contains proteins and antibodies produced by the body’s immune system to fend off invasive pathogens, such as SARS-CoV-2. To qualify as a plasma donor for COVID-19 patients, donors must be at least 17 years old and weigh 110 pounds; be in good health; and have a prior, verified diagnosis of COVID-19 but are now symptom-free and fully recovered. The UC San Diego Health clinical trial will recruit a total of 487 qualifying participants for the study. Criteria to qualify for participation include a high-risk factor, such as age or an underlying condition, like cardiovascular disease, diabetes, existing pulmonary impairment or employment as a health care worker; known exposure to SARS-CoV-2; and a negative PCR diagnostic test to show no current infection. Testing will be conducted inside tents set up across from the emergency department at Jacobs Medical Center and the Altman Clinical and Translational Research Institute (ACTRI) on the La Jolla health campus. The UC Health Blood Bank is coordinating efforts with the San Diego Blood Bank. The ACTRI is providing personnel, infrastructure support and other resources for the CP trial and for other COVID-19-related clinical trials at UC San Diego. In addition, the ACTRI has created a COVID-19 Biobank to provide materials for research projects to diagnose or treat the disease. In cases of infection by the novel coronavirus, it appears the human immune system begins producing antibodies to the disease five to 10 days after the initial infection. The antibodies bind to the targeted coronavirus, stopping it from latching onto new cells and beginning the production of more viral particles. Over the course of two or so weeks, the body clears out the virus, but antibodies to it (or the blueprints for making them) remain. The depth and length of subsequent immunity have not been determined. Cachay said he thinks CP will likely be most effective in persons with early exposure to the novel coronavirus, before symptoms appear, but it will require a clinical trial to substantiate that thinking. “If we don’t do this, if we just gather anecdotal evidence that isn’t conclusive, then we won’t be any better off when the next wave hits.” To read the original article click here.

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Researchers Create Air Filter That Can Kill the Coronavirus

AHA Publisher — Wed, 08 Jul 2020 07:00:07 +0000

University of Houston via EurekAlert – Researchers from the University of Houston, in collaboration with others, have designed a “catch and kill” air filter that can trap the virus responsible for COVID-19, killing it instantly. Zhifeng Ren, director of the Texas Center for Superconductivity at UH, collaborated with Monzer Hourani, CEO of Medistar, a Houston-based medical real estate development firm, and other researchers to design the filter, which is described in a paper published in Materials Today Physics. The researchers reported that virus tests at the Galveston National Laboratory found 99.8% of the novel SARS-CoV-2, the virus that causes COVID-19, was killed in a single pass through a filter made from commercially available nickel foam heated to 200 degrees Centigrade, or about 392 degrees Fahrenheit. It also killed 99.9% of the anthrax spores in testing at the national lab, which is run by the University of Texas Medical Branch. “This filter could be useful in airports and in airplanes, in office buildings, schools and cruise ships to stop the spread of COVID-19,” said Ren, MD Anderson Chair Professor of Physics at UH and co-corresponding author for the paper. “Its ability to help control the spread of the virus could be very useful for society.” Medistar executives are is also proposing a desk-top model, capable of purifying the air in an office worker’s immediate surroundings, he said. Ren said the Texas Center for Superconductivity at the University of Houston (TcSUH) was approached by Medistar on March 31, as the pandemic was spreading throughout the United States, for help in developing the concept of a virus-trapping air filter. Luo Yu of the UH Department of Physics and TcSUH along with Dr. Garrett K. Peel of Medistar and Dr. Faisal Cheema at the UH College of Medicine are co-first authors on the paper. The researchers knew the virus can remain in the air for about three hours, meaning a filter that could remove it quickly was a viable plan. With businesses reopening, controlling the spread in air conditioned spaces was urgent. And Medistar knew the virus can’t survive temperatures above 70 degrees Centigrade, about 158 degrees Fahrenheit, so the researchers decided to use a heated filter. By making the filter temperature far hotter – about 200 C – they were able to kill the virus almost instantly. Ren suggested using nickel foam, saying it met several key requirements: It is porous, allowing the flow of air, and electrically conductive, which allowed it to be heated. It is also flexible. But nickel foam has low resistivity, making it difficult to raise the temperature high enough to quickly kill the virus. The researchers solved that problem by folding the foam, connecting multiple compartments with electrical wires to increase the resistance high enough to raise the temperature as high as 250 degrees C. By making the filter electrically heated, rather than heating it from an external source, the researchers said they minimized the amount of heat that escaped from the filter, allowing air conditioning to function with minimal strain. A prototype was built by a local workshop and first tested at Ren’s lab for the relationship between voltage/current and temperature; it then went to the Galveston lab to be tested for its ability to kill the virus. Ren said it satisfies the requirements for conventional heating, ventilation and air conditioning (HVAC) systems. “This novel biodefense indoor air protection technology offers the first-in-line prevention against environmentally mediated transmission of airborne SARS-CoV-2 and will be on the forefront of technologies available to combat the current pandemic and any future airborne biothreats in indoor environments,” Cheema said. Hourani and Peel have called for a phased roll-out of the device, “beginning with high-priority venues, where essential workers are at elevated risk of exposure (particularly schools, hospitals and health care facilities, as well as public transit environs such as airplanes).” That will both improve safety for frontline workers in essential industries and allow nonessential workers to return to public work spaces, they said. To read the original article click here.

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The Most Promising Strategies for Defeating Coronavirus

AHA Publisher — Sat, 25 Apr 2020 07:00:22 +0000

Frontiers via EurekAlert – In an unprecedented effort, hundreds of thousands of researchers and clinicians worldwide are locked in a race against time to develop cures, vaccines, and better diagnostic tests for COVID-19, the illness caused by the virus SARS-CoV-2. Over 1,650 articles on COVID-19 are already listed in databases such as Google Scholar, while dozens more are added daily. The register ClinicalTrials.gov lists over 460 ongoing clinical trials on COVID-19, although the majority are still in the earliest stages. Given the diversity of experimental approaches among these studies, a systematic review of possible clinical strategies is timely and welcome. In a new study in Frontiers in Microbiology, aimed at the research community but also comprehensible for non-specialists, experts from the University of North Carolina at Chapel Hill review possible strategies against dangerous coronaviruses – not only SARS-CoV-2 and its relatives such as SARS-Cov (causing Severe Acute Respiratory Syndrome, SARS) and MERS-Cov (causing Middle East Respiratory Syndrome, MERS), but also as yet unknown strains which will inevitably emerge in the future. They propose that the most promising approaches for fast progress are selected antivirals such as remdesivir, and gene therapy. “Coronaviruses represent a true threat to human health and the global economy. We must first consider novel countermeasures to control the SARS-Cov-2 pandemic virus and then the vast array of high-threat zoonotic viruses that are poised for human emergence in the future,” says Dr Ralph Baric, William R. Kenan, Jr. Distinguished Professor in the Department of Epidemiology and Professor in the Department of Microbiology and Immunology at UNC Chapel Hill. “To help focus the global search for a treatment, we here aim to provide a comprehensive resource of possible lines of attack against SARS-Cov-2 and related coronaviruses, including the results from all preclinical and clinical trials so far on vaccines against SARS and MERS.” The authors discuss one-by-one the possible strategies against the coronavirus. First, and most effective are vaccines. In the present case, the most successful are likely to carry the Receptor Binding Domain (of the virus’s S-protein), which allows it to bind to and fuse with host cells. Besides the traditional live attenuated, inactivated, and subunit-based vaccines, modern types such as DNA/RNA-based and nanoparticle- or viral vector-borne vaccines should be considered. Because the amino acid sequence of the S-protein is very different across coronaviruses (e.g., 76-78% similarity between SARS-Cov and SARS-Cov-2), vaccines against one strain typically won’t work against another. But because the development and testing of new vaccines takes one to several years, other approaches are essential in the meantime. The second-most likely effective are broad-spectrum antivirals such as nucleoside analogs, which mimic the bases in the virus’s RNA genome and get mistakenly incorporated into nascent RNA chains, stalling the copy process. But because coronaviruses have a so-called “proofreading” enzyme which can cut such mismatches out, most nucleoside analogs don’t work well. Exceptions seem to be β-D-N4-hydroxycytidine and remdesivir, proposed by the authors as good candidates against SARS-Cov-2. Third, convalescent blood plasma from patients who recovered, with low levels of a range of antibodies against the virus; or preferably (but slower to develop), monoclonal antibodies, isolated and mass-produced through biotechnology. Such “passive immunization” can give short-term immunity. The authors discuss a range of options from fusion inhibitors, to inhibitors of human proteases, to immune modulators such as corticosteroid hormones, and others. Finally, and in the authors’ view the most attractive alternative until a vaccine is produced, is gene therapy delivered through the adeno-associated virus (AAV). This would entail the fast, targeted delivery of antibodies, immunoadhesins, antiviral peptides, and immunomodulators to the upper airways, to give short-term protection. Because the rapid turnover of cells here, risks of toxicity are minimal. They estimate that such tools can be developed, adapted, and tested within a month. “AAV-based passive immunization can be used as a quick alternative. It is straightforward and only contains two components, the viral vector and the antibody. Multiple AAV vectors have been proven to be safe and effective for human use,” says author Dr Long Ping Victor Tse. “In theory, a single dose could mount a protective response within a week and last for more than a year. The currently high price could be reduced when treating infectious diseases, which have a larger market. It may or may not already be too late to use AAV to treat SARS-CoV-2, but it is certainly not too late for future outbreaks.” To read the original article click here.

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COVID-19 Tip Sheet: Story Ideas From Johns Hopkins

AHA Publisher — Wed, 22 Apr 2020 07:00:47 +0000

Johns Hopkins Medicine via Newswise – When SARS-CoV-2, the virus that causes COVID-19, attacks the body, the kidneys are among the earliest organs to be affected. Viral damage to kidney cells can lead to fluid imbalance, electrolyte loss, lack of blood pressure regulation and many other negative consequences that can make recovery more difficult to achieve. However, for the thousands of Americans with kidney disease, the hazards of COVID-19 are even greater. Newswise — In a viewpoint article in the April 6, 2020 issue of the Journal of Clinical Investigation, Johns Hopkins Medicine nephrologist Hamid Rabb, M.D., examines the major challenges that kidney patients face when dealing with COVID-19 and suggests ways to address them. For example, Rabb notes that the 500,000 hemodialysis patients in the United States are at high risk for contracting COVID-19 because they are immunocompromised and have to “visit densely populated outpatient units three times per week” for treatment. He says that increasing the use of home dialysis — a goal of the U.S. Department of Health and Human Services even before the pandemic — “should be hastened to reduce incidence of COVID-19 infections.” Patients who have undergone kidney transplants are another group vulnerable to COVID-19 and its complications because they often take immunosuppressive medications to prevent rejection of the received organ. Rabb, who is available for interviews, also urges physicians to look for signs of acute kidney injury in patients being treated for COVID-19, especially the elderly. The condition can be a consequence of the virus, he warns, and it increases the risk of death during hospitalization. MENTAL HEALTH CHALLENGES IN RECOVERY FROM SEVERE COVID-19 INFECTION Up to 20% of patients hospitalized in an intensive care unit (ICU) experience symptoms of post-traumatic stress disorder (PTSD), which may include fear, anxiety, agitation and isolation when subjected to a triggering memory of the event. Early reports from China suggest that rates of PTSD may be particularly high in patients recovering from COVID-19. Psychiatrist O. Joseph Bienvenu, M.D., Ph.D., says that particular circumstances surrounding the pandemic may be contributing to this increase. Patients being treated for COVID infections are in quarantine situations with visitor restrictions in place on hospitals and physical separation from loved ones when they return home. People who have recovered COVID may also face a stigma related to their physical illness as well as their mental health, and there may be a lack of access to social support. Bienvenu is available to speak about the unique mental health challenges that COVID patients face during their recovery and ways that we can address these challenges. CORONAVIRUS DRUG DEVELOPMENT Current drug development efforts for COVID-19 mostly focus on repurposing existing drugs to prevent the virus from making more copies of itself. However, these available drugs may not be as effective as drugs targeting coronaviruses more specifically. In addition, different approaches may be needed in the event of drug resistance. Cocktail therapy with multiple drugs targeting different viral proteins will likely increase efficiency and thwart resistance, as is the case for HIV treatment. Molecular biologist Anthony Leung, Ph.D., and virologist Diane Griffin, M.D., Ph.D., are applying their research on a class of viral enzymes to potentially develop coronavirus treatments. They have shown that a class of enzymes are critical for virus replication and may play a role in disease development. In collaboration with the Johns Hopkins Drug Discovery and ChemCore groups, the research team will screen a library of 100,000 compounds to identify ones that block the activities of these enzymes. This library will consist of FDA-approved drugs, clinical trial drug candidates and natural products. They will then test the drug leads in cell culture and animal models for their effectiveness against coronaviruses. The specific viral enzymes under investigation remove the chemical ADP-ribose — a combination of an energy molecule and a sugar — off of proteins known as ADP-ribosylation hydrolases. Added when a protein is made, these chemical ADP-riboses give the proteins a function in the cell, and then the ADP-ribose-remover enzymes take off the chemicals so they can be recycled when the protein has finished its job. Leung and Griffin are available to discuss this very early-stage project. TREATMENT FOR OPIOID USE DISORDER DURING THE PANDEMIC People with opioid use disorder are one of the populations that shouldn’t be overlooked during the pandemic. Patients with substance use disorders face multiple challenges aside from being able to gain access to medications necessary for their treatment, including poverty, a lack of access to affordable housing and difficulties from other chronic health conditions. Kenneth Stoller, M.D., director of the Johns Hopkins Broadway Center for Addiction, is available for comment on clinical and provider measures being used to care for substance use disorder patients during the coronavirus crisis. He says that accessing care for new individuals seeking treatment may be more challenging at this time, as fewer treatment programs are accepting new patients, and those that are may be limiting numbers due to logistics involved with distancing precautions and conservation of personal protective equipment. Opioid treatment programs that are accepting new patients may be less likely to offer methadone as opposed to buprenorphine due to the requirement for an in-person exam. In-person meetings are being avoided, and alternatives may include consultations via phone or audiovisual technologies. More take-home doses of medication are being offered to minimize travel to and from programs. This also results in less patient contact. With the hope of decreasing risk for drug relapse, overdose and social isolation due to the limited face-to-face patient/provider interaction and altered medication regimen, health care providers such as Stoller recommend patients connect with family and friends who contribute to positive behaviors and can encourage them during their drug recovery process. Patients are also encouraged to connect with mutual support groups virtually, as well as with peer recovery specialists, spiritual communities, and other people or groups that can support their efforts to create a strong recovery in these challenging circumstances. Brendan Saloner, Ph.D., is available to discuss policy and systems regarding opioid use disorder treatment during the coronavirus crisis. Newly updated federal guidelines implemented during the crisis allow patients facing opioid use disorder to take advantage of benefits and flexible services offered virtually by Medicaid and private insurance programs. In addition to the new telemedicine options for virtual health care visits, some of the public policies enacted for treating people facing opioid use disorder include safer delivery of treatments for patients and staff and waiving required in-person urine drug testing to adhere to social distancing guidelines. Based on recommendations from the Substance Abuse and Mental Health Services Administration, some patients who are on a stable medication regimen can receive up to 28 days of medication for at-home use, including being prescribed naloxone to reverse potential drug overdoses. Saloner says that additional funding and incentives for telehealth visits, phone outreach and access to other services such as food and housing would lift a heavy burden from patients facing substance use disorder amid the coronavirus crisis. REHABILITATION AT A DISTANCE AFTER STROKE DURING A PANDEMIC After suffering from a stroke or another brain injury, patients require targeted physical rehabilitation to aid their recovery, which can include physical, occupational, speech and psychological therapy. The coronavirus pandemic has had a tremendous impact on the way care is provided to these patients as well as how and when they are discharged home to the care of their loved ones. When a patient is discharged from the hospital, it is just the beginning of their journey toward recovery. They are usually still frail and vulnerable to medical complications. In addition, there are often safety concerns due to new disability. Doctors including Preeti Raghavan, M.B.B.S., director of the Center of Excellence in Stroke Treatment, Recovery and Rehabilitation at the Sheikh Khalifa Stroke Institute, and her team are working diligently to provide care for their patients within the hospital setting while determining how patients can receive adequate rehab at a distance once the patient has been discharged from the hospital. The teams have set up a stroke interdisciplinary telemedicine clinic to ensure that patients are evaluated in a timely fashion. Patients are seen by the stroke neurology team and physical therapist in a telemedicine visit within a week after discharge to address any safety concerns — these may be medical, pharmaceutical or physical needs. Within two weeks after discharge, patients are seen by the physical medicine and rehabilitation physician and an occupational therapist to assess function and determine a plan of action. Individuals with language and/or swallowing deficits may also be seen by a speech therapist. These collaborative physician-therapy visits help therapist familiar with the patient’s medical issues ensure the patient receives the rehabilitation they need. Physical, occupational and speech therapists plan the patient’s telerehabilitation visits and assemble kits to facilitate telerehabilitation at home to aid patients during their path to recovery. Raghavan is available to discuss how rehabilitation experts are addressing the challenges of social and physical distancing when rehabilitation care is needed. She is also able to comment on how — during a pandemic — experts might still provide the needed continuum of care for non-COVID-19 healthcare needs, such as stroke recovery. PAIN MANAGEMENT DURING THE CORONAVIRUS PANDEMIC As our medical systems are strained by COVID-19, health care providers find themselves weighing the risk of exposure for front-line care workers against the benefits of patients receiving treatment in the clinic. This is especially salient for an estimated 50 million Americans with chronic pain. A panel of experts in pain treatment convened to create guidelines for best practices in pain management during times of public health crisis such as the COVID-19 pandemic. Johns Hopkins Medicine pain expert Steven P. Cohen, M.D., chaired the panel and is available to speak about the proposed guidelines and moral and ethical conundrums pain management physicians are facing each day. This article has been modified. To read the original article click here.

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Immune-Boosting Home Exercise Plan – No Equipment Needed

AHA Publisher — Mon, 20 Apr 2020 07:00:18 +0000

Dr. Don Colbert – As “stay at home” orders continue for most of the country during this COVID-19 pandemic, it’s vital that we all take care of our bodies. We’ve discussed many ways to eat for your best immune function. But, did you know that exercise is also vital for a healthy immune system? Here, we discuss how exercise helps and an easy immune-boosting full-body home exercise plan. You don’t need equipment, just 20-30 minutes per day, 5 days per week. How does a full-body home exercise plan help immune function? It can: Reduce system inflammation, allowing the immune system to fight viruses and bacteria more efficiently (1) Reduce any high blood sugars, which are associated with higher incidences of infection Lower the risk of obesity and diabetes, both of which are associated with more disease What’s more, if you’re able to take this easy plan outside in your yard or a park (alone), you’ll also get the amazing mood-boosting benefits of outdoor exercise (2). Immune-Boosting Full-Body Home Exercise Plan This simple plan uses 5 different exercise moves, designed to work your upper body, core, and lower body. It also combines both body-weight strength training with varying intensities of cardiovascular exercise. It’s great for your heart (3), brain, and whole body. Of course, only partake in an exercise that you are healthy enough to try. Talk to your doctor if you have concerns. 1. PLANKS Start with planks. Planks have been shown to tone and condition your core and glutes, including the transverse abdominals. Having a strong core can reduce back pain, improve full-body muscle coordination, and reduce knee and leg injury. To perform a Straight-Arm Plank: Plant hands directly under shoulders (slightly wider than shoulder-width) like you’re about to do a push-up. Keep toes on the floor and squeeze glutes to stabilize your body. Your legs should be activated. Do not lock or hyperextend your knees. Look at a spot on the floor about one foot beyond your hands to neutralize your neck and spine. Your body should be straight and your head should be in line with your back. Start by holding this position for 20 seconds, increasing time as you become more comfortable. But, don’t compromise the posittion or let your hips sag. Keep core tight and body straight. Forearm Plank: If you’d like to try the forearm plank variation, simply place forearms on the floor with elbows aligned below shoulders and arms parallel to your body at about shoulder width. If flat palms bother your wrists, clasp your hands together. Side Plank: Lie on your side with one leg stacked on top of the other, then prop your body up on your hand or elbow while keeping feet stacked. If you are not familiar with the body position for planks, take some time to look them up on youtube, etc. You’ll find many great instructional videos. Advanced Options: 6-Minute Planks: Try planking for 5 minutes per day by starting in the straight-arm plank for 30 seconds, moving to side planks for 15 seconds each, and finishing in forearm plank for 30 seconds. Then, rest 30 seconds. Repeat plank series 2 more times. 2. PUSH-UPS Since you’ve already mastered a plank, the positioning for push-ups is easy. Start in the same position as a straight-arm plank, keeping your body straight as a board. If needed, drop your knees to the floor rather than staying up on your toes. Keep your body straight in either position. Your hands should be shoulder-width apart, or a little bit wider, fingers splayed. Then, bend your elbows and lower toward the ground. Continue until you are near the ground, close enough for your nose to touch, and then push back up. If this is too hard to start, lower until your elbows are at about a 45-degree angle. Keep your core engaged and back flat. Do not let your hips sag. Try 5 push-ups to start, and work your way up to 10-20 push-ups at a time. Advanced Options: To take it to the next level, set a goal of doing 50 push-ups per day for the next 30 days. You’ll be astounded at how much stronger you will end than where you began. 3. WALKING LUNGES Next, to continue to work the core and glutes, and add the legs, try walking lunges. It’s easiest if you have space such as a hallway to perform several in a row, but you can use smaller spaces if needed. To do a walking lunge: Start by standing upright with your feet together. Then, take a large controlled step forward with your right leg. Lunge by lowering your hips toward the floor so that your front leg/knee forms a 90-degree angle and your back leg/knee lowers towards the floor (but not touching) bending in its own 90-degree angle. Your front leg knee should be directly above your foot. Press your right heel into the ground. Then, push off with your left foot and bring it forward in a large, controlled step, repeating the same motion with your left leg forward. This is 2 lunges. Advanced Options: To add more calf work, raise up onto your toe between lunges. You can also increase the difficulty of walking lunges by adding 5 to 8-pound weights in each hand. 4. MOUNTAIN CLIMBERS Mountain climbers are a great way to work your upper body, core, legs, and heart. To do mountain climbers first get into a straight-arm plank position. Distribute your weight evenly between your hands and your toes. Your hands should be about shoulder-width apart, back flat, abs engaged, and head in alignment. Then, pull your right knee into your chest as far as you can. Next, switch, pushing your right knee back to the original position and bringing your left knee to your chest. Essentially, your running in a plank position. Start with 30 total mountain climbers (15 with each knee). Work your way to 50. Advanced Options: As you progress, try doing 100 mountain climbers (50 with each knee) at a time. You can also add high-intensity intervals by slowing to a moderate pace for 10, and then increasing to high intensity for 10, and repeating. 5. RUNNING IN PLACE OR JUMPROPE Next, stand upright and engage in 5 minutes of running. If homebound, try running in place. If you’re able to get outside and walk (at a fast pace), jog, or run, this is even better. Or, if you have a jump rope (or most any rope) handy, you’ll get a great full-body workout. Try: Indoor running in place: Raise one arm up and lift the opposite foot up at the same time so that your knee comes up to the same height as your hips. Quickly hop from one foot to the other and at the same time swing your front arm back and the other arm forwards and up. For a 5-minute run, consider alternating minute to minute with high-knee running and butt-kick running. Walking, jogging, or running outside: Go out for at least 5-10 minutes. No matter whether your walking, jogging, or running, try using intervals by going at your normal pace (moderate) for 1 minute, and then increasing to high intensity for 1-2 minutes. Jumprope indoors or outdoors: If you haven’t jumped rope in a while, this one will be tough to start but very rewarding. Try 5-10 minutes. Use a standard two-footed hop jump or a running motion jump. Bottom Line Exercise is important for brain health, heart health, and strength. And, while our world is battling COVID-19, it’s important to remember that it’s also good for the immune system. Exercise does not have to be difficult, confusing, or require equipment. There are great exercises, utilizing body-weight, you can do in your own home, yard, or neighborhood. Use these and other great at-home habits to stay strong and healthy. To read the original article click here. For more articles from Dr. Colbert click here.

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Indoor Precautions Essential to Stem Airborne COVID-19

AHA Publisher — Fri, 17 Apr 2020 07:00:20 +0000

Queensland University of Technology via EurekAlert – Researchers are urging health authorities to immediately recognise the role of airborne transmission of COVID-19 virus droplets from an infected person beyond 1.5m in order to stem the disease’s spread. World-leading air quality and health expert QUT Professor Lidia Morawska and Professor Junji Cao from Chinese Academy of Sciences in an article in Environment International published this week called on health bodies to initiate research into the airborne transmission of COVID-19 as it is happening. “National health bodies responsible for controlling the pandemic are hampered by not acknowledging the research evidence of airborne transmission of viable virus droplets, that was conducted after the SARS 2003 outbreak,” Professor Morawska said. “Now is the ideal time to conduct research into how viruses can travel on the airflow, because there are many similarities between the coronavirus that caused SARS and the COVID-19 coronavirus and therefore it is highly likely that COVID-19 spreads by air. “Analysis of the initial pattern of COVID-19 spread in China reveals multiple cases of non-contact transmission, especially in areas outside Wuhan. “On numerous cruise ships where thousands of people onboard were infected, many of the infections occurred after passengers had to isolate in their cabins even though hand hygiene was implemented. “Therefore, the ventilation system could have spread the airborne virus between the cabins. “We know that Covid-19’s predecessor, SARS.CoV-1, did spread on the air in the 2003 outbreak. Several studies have retrospectively explained this pathway of transmission in Hong Kong’s Prince of Wales Hospital as well as in healthcare facilities in Toronto, Canada. “A WHO review (2009) of the evidence found viral diseases can be transmitted across distances in indoor environments by aerosol or airborne infection and can result in large clusters of infection in a short period.” Professor Morawska said authorities need to put in place public health precautions to lower airborne transmission by: increased ventilation of indoor spaces use of natural ventilation avoiding air recirculation avoiding staying in another person’s direct air flow minimizing the number of people sharing the same environment providing adequate ventilation in nursing homes, hospitals, shops, offices, schools, restaurants and cruise ships. Professor Morawska said virus droplets’ liquid content started to evaporate immediately after being exhaled and some became so small that could travel on air currents, rather than fall to the ground as larger droplets do. “Such small droplets can carry their viral content metres, even tens of metres, away from the infected person.” Professor Morawska said it was difficult to directly detect viruses travelling in the air because it took knowledge of the air flow from an infected person and a long sampling period to collect enough copies of the viruses. “Air transmission research should be undertaken now and its likelihood as a means of spread should be taken seriously with due precautions taken now. “We have already lost valuable time by ignoring this method of spread and we should act on the presumption that COVID-19 is spreading on the air.” To read the original article click here.

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Novel Coronavirus Attacks and Destroys T Cells, Just Like HIV

AHA Publisher — Thu, 16 Apr 2020 07:00:42 +0000

Angela Betsaida B. Laguipo, BSN via News-Medical Net – The immune system has many components that work together in protecting the body from foreign invaders. One of the most important types of immune cells is T lymphocytes or T cells, a type of white blood cell that acts as the core of adaptive immunity, the system that modifies the immune response to specific pathogens. Now, a team from the United States and China revealed evidence that the coronavirus disease, caused by the severe acute respiratory syndrome coronavirus (SARS-CoV-2), attacks the immune system’s T lymphocytes. The worrying findings highlight the destructive power of the novel coronavirus, which can destroy the immune system, leaving the patient unable to fight off the infection. The Novel Coronavirus Coronaviruses have been causing problems in humans for a long time. Though many versions of the virus are known to trigger only mild symptoms such as common colds. However, three recent types of coronavirus have caused deadly diseases – the severe acute respiratory syndrome (SARS) in China in 2002, the Middle East respiratory syndrome (MERS) in Saudi Arabia in 2012, and the current global pandemic, the coronavirus disease (COVID-19), which first emerged in Wuhan City, Hubei Province, in China December 2019. The impact of the previous coronavirus outbreaks in 2002 and 2012 has been mild compared with the mayhem unleashed by the SARS-CoV-2. Within only a few months, the novel coronavirus has prompted most countries to go into lockdown, dwindling economies, and overwhelming health care systems with the more than 2 million people infected. Meanwhile, scientists across the globe are racing to understand the SARS-CoV-2-in the hope of finding a treatment or cure. Now, the researchers’ surprise discovery has shed light on the potency of the novel coronavirus is killing powerful immune cells, which are supposed to kill the virus instead. Taken as Hostage The researchers from the Fudan University in Shanghai, China, and the New York Blood Centre, has studied the virus’s action on T-lymphocyte cell lines. T lymphocytes or T cells work by identifying and eliminating foreign invaders in the body. To arrive at their findings, published in the journal of Cellular & Molecular Immunology, the team captured a cell infected by the virus, penetrated the membrane, and injected toxic chemicals into the cell. After this, the chemicals killed both the virus and infected cells by tearing them into pieces. Surprisingly, the team has found that when the coronavirus and the T cell came into contact with each other, the T cell became prey to the coronavirus, wherein a structure in the spike of the coronavirus triggered the attachment of a viral envelope and the cell membrane. After, the genes of the virus entered the T cell and overwhelmed it, took it hostage, and deactivated its ability to protect the body. The team then tried to do the same with the SARS virus, and another coronavirus, but these pathogens were not able to infect T cells. The researchers suspect that the SARS virus, which caused an outbreak in 2002 to 2003, has a lack of a membrane fusion function. The virus can only infect cells that have a particular receptor protein called the angiotensin-converting enzyme 2 (ACE2). T cells contain only a few ACE2 receptor proteins. It is an important discovery, knowing the effect of the SARS-CoV-2 on T cells, since this may show why the disease is spreading so quickly, and infecting so many across the globe. It also explains why certain vulnerable populations are at a high risk of dying from the infection, including those who are more than 65, those who are immunocompromised, and those with underlying medical conditions like lung disease, heart disease, diabetes, and hypertension. Further investigation shows that patients who died from COVID-19 had damage to their bodies similar to both SARS and HIV. Also, the team found that unlike HIV that replicates faulty T cells, the coronavirus does not replicate, showing that the T cells and the virus may end up dying together. To read the original article click here.

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Study Finds Remdesivir Effective Against a Key Enzyme of Coronavirus that Causes COVID-19

AHA Publisher — Tue, 14 Apr 2020 07:00:21 +0000

University of Alberta Faculty of Medicine & Dentistry via EurekAlert – Remdesivir already in human trials in search for treatment of deadly disease. Scientists at the University of Alberta have shown that the drug remdesivir is highly effective in stopping the replication mechanism of the coronavirus that causes COVID-19, according to new research published todayin the Journal of Biological Chemistry. The paper follows closely on research published by the same lab in late February that demonstrated how the drug worked against the Middle East Respiratory Syndrome (MERS) virus, a related coronavirus. “We were optimistic that we would see the same results against the SARS-CoV-2 virus,” said Matthias Götte, chair of medical microbiology and immunology at U of A. “We obtained almost identical results as we reported previously with MERS, so we see that remdesivir is a very potent inhibitor for coronavirus polymerases.” Götte’s new paper demonstrates how remdesivir, developed in 2014 to fight the Ebola epidemic, works in detail. He likens the polymerase to the engine of the virus, responsible for synthesizing the virus’ genome. “If you target the polymerase, the virus cannot spread, so it’s a very logical target for treatment,” Götte said. The lab’s work shows how remdesivir tricks the virus by mimicking its building blocks. “These coronavirus polymerases are sloppy and they get fooled, so the inhibitor gets incorporated many times and the virus can no longer replicate,” Götte explained. He said the evidence from his group, along with previously published studies in animal and cell culture models, means that remdesivir can be classified as a “direct-acting antiviral” against SARS-CoV-2, a term first used to describe newer classes of antivirals that interfere with specific steps of the hepatitis C virus (HCV) life cycle. He said the discovery of that direct action reinforces the promise of clinical trials for remdesivir in COVID-19 patients, which are already underway around the world. While Götte said the evidence justifies clinical trials, he cautioned that the results obtained in the lab cannot be used to predict how the drug will work with people. “We’ve got to be patient and wait for the results of the randomized clinical trials,” said Götte, whose research was funded by the Canadian Institutes of Health Research, Alberta’s Major Innovation Fund and Gilead Sciences, which manufactures remdesivir. The Götte lab previously worked on human immunodeficiency virus (HIV) and HCV, but a couple of years ago switched to focus on viruses with the highest epidemic potential. The World Health Organization (WHO) issued its list of the top pathogens likely to cause severe outbreaks, including Ebola, Lassa and coronaviruses, in 2015. “In that sense we were prepared because my lab specializes in viral polymerases,” said Götte, adding that his next step will be to use his lab’s tools to evaluate other promising antivirals. He is optimistic that the unprecedented amount of research going on worldwide and the high level of co-operation between researchers will lead to the discovery of one or more effective treatments for COVID-19. “We are desperate, but we still have to keep the bar high for anything that we put into clinical trials,” he said. Remdesivir is one of several drugs being fast-tracked into trials by the World Health Organization, comparing potential treatments in hospitalized COVID-19 patients in a dozen countries, including Canada. Götte said we can expect results from important clinical trials as early as April or May. Götte said it is disappointing that antivirals discovered at the time of the severe acute respiratory syndrome (SARS) outbreak of 2003–which might have been effective against COVID-19 too–were never translated into widely available treatments, largely because of the huge cost involved in developing new drugs. “This time around it’s obvious that we have to cross the finish line,” he said. “Ten billion dollars, it seems a lot, a huge amount,” Götte said. “But in the context of this pandemic and the costs associated with this pandemic, it’s nothing.” To read the original article click here.

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