At a Glance
SARS-CoV-2, the virus that causes COVID-19, can trigger a life-threatening condition called acute respiratory distress syndrome (ARDS), in which fluid leaks into the lungs andpreventsoxygen from passing into the body. Other complications of COVID-19 include systemic inflammation and cardiovascular complications.
Previous studies have found changes in the makeup of lung immune cells in patients with COVID-19. But it isnt clear if COVID-19 causes similar changes to immune cells in heart tissue. Nor is it clear if such changes help contribute to cardiovascular complications.
An NIH-funded research team, led by Dr. Matthias Nahrendorf at Massachusetts General Hospital and Dr. Jana Grune at the German Heart Center at Charit in Berlin, investigated how ARDS-associated immune signals affect heart tissue and cardiovascular health. The study appeared in the journal Circulation on March 20, 2024.
The team examined heart tissue specimens from 21 people who died with SARS-CoV-2-associated ARDS. They compared these to specimens from 33 people who died from non-COVID-19 causes from before the COVID-19 pandemic. They focused on a type of immune cells called macrophages, which greatly multiply during ARDS. Macrophages engulf and digest pathogens. One type of macrophage normally lives in heart tissue, where they clear out pathogens and support metabolism in the heart muscle. Another type can accumulate in response to tissue damage and promote inflammation.
Heart tissue from people with COVID-19 had more macrophages than tissue from controls. More of the macrophages were of the inflammatory type, too. The researchers observed similar results in mice infected with SARS-CoV-2.
The team wanted to find out how SARS-CoV-2 infection led to the observed changes in heart macrophages. To do so, they developed a way to induce ARDS in mice without any virus infection. This virus-like ARDS (VLARDS) led to the same changes in heart macrophages as those seen in SARS-CoV-2 infection. Blocking part of the inflammatory response prevented these changes and preserved heart function. Mice with VLARDS were also more likely to die if they had pre-existing heart failure.
The results suggest that SARS-CoV-2 increases the inflammatory share of macrophages in the heart, leading to heart damage. This change appears to result from the immune response to lung injury rather than from viral infection of the heart itself. Targeting pro-inflammatory heart macrophages might thus relieve the cardiovascular complications of SARS-CoV-2. Dialing back the bodys immune response might also be an effective treatment.
These findings can also be applied more generally, Nahrendorf notes, as our results suggest that any severe infection can send shockwaves through the whole body.
by Brian Doctrow, Ph.D.
Funding:NIHs National Heart, Lung, and Blood Institute (NHLBI); German Research Foundation (Deutsche Forschungsgemeinschaft); Corona-Stiftung; German Society for Cardiology; German Centre for Cardiovascular Research; Canadian Institutes of Health Research.
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On a hot, sunny day in March 2024, Basanti Akka, a village health worker (VHW) from the non-governmental organisation Jan Swasthya Sahyog (JSS) walked to Seema Kujar's home in Aurapani, a village in the central Indian state of Chhattisgarh.
Kujar's baby, just 18 days old, was showing symptoms of a cold, and the young mother was worried. Even mild respiratory symptoms can turn into pneumonia. Here, in rural Bilaspur district, where advanced medical care is difficult to access, that can be especially dangerous.
Aurapani is home to a "tribal" community, meaning an indigenous people formally considered economically and socially marginalised in India. Just under a third of Chhattisgarh is tribal, and more than half of that population lived below the poverty line as recently as 2012.
Many tribal villages are located in forests, poorly served by basic amenities, including roads. And while the number of primary health centres (PHCs) serving rural parts of the state increased significantly between 2002 and 2021, according to a National Health Mission report, more than 40% of posts for doctors at those PHCs remained vacant. In conditions like these, village-level health workers, like the JSS VHWs, or like government Mitanin workers who typically rely on just basic medical training are indispensable.
Kujar fed the infant as Akka asked a series of 20 questions. Was the child eating regularly? Were there signs of a fever? Was the baby active? She consulted her phone for further guidance open on its screen was an app called Shwaas, a word thattranslates to "breath".
Developed in the crisis phase of the pandemic by family medicine and public health specialist Dr Gajanan Phutke, together with a team drawn from JSS and a Bengaluru-based tech non-profit, the Samanvay Foundation, Shwaas was first used to help frontline health workers diagnose COVID-19 cases. Between October 2020 and March 2021, JSS frontline workers screened more than 2,000 patients in 72 villages for the coronavirus, guided by the app.
In 2022, as COVID-19 subsided in India, the medical team at JSS proposed that Shwaas could be retooled to detect other diseases specifically pneumonia, since the app comes with an in-built breath-counter facility . According to UNICEF, 11% of deaths in Indian children under five years old each year are a result of pneumonia; in Chhattisgarh, nearly 1,000 children under five, the vast majority of them infants, were officially reported to have died of pneumonia in 20222023 alone. Tachypnoea, or abnormally rapid breathing, can be a sign of pneumonia but counting a child's respiratory rate by visual judgement alone is difficult. Simple breath-counter tools have been shown to significantly help frontline workers achieve correct diagnoses.
"During COVID-19, we realised that we didn't have enough breath-counting machines, and we didn't have the time to produce more and train people as well. Rapid scale was not possible with the machines and training," Dr Phutke explains. "We ended up using paper and pen because of the urgency, but soon we digitised the process to support our senior health care workers.
"We developed an algorithm that asked 20 simple questions to help the frontline workers notice the immediate danger signs. The significance of this app is that it addresses the power of decision-making of VHWs, who are neo-literate. It empowers the local health workers to decide whether the patient needs to go to the hospital. This was very important during COVID when hospital beds were running short. Now we use it to save lives from pneumonia. The solutions we design in our area are for everyone in India, and we know that if it works in our tribal areas, it will work anywhere."
Over the past four years, JSS has trained 150 frontline health workers to use the Shwaas app. In 2023, across 72 villages, 12,811 patients with fevers and respiratory symptoms were screened with Shwaas.
When Basanti counted the number of children under five she had screened with help from the app, she realised that she had referred no fewer than 75 children who might otherwise have become precipitously sicker at home for facility-based care. She appeared astonished by the scale of her intervention, and sobered by the thought of the tragic outcomes she might have helped avert. "We never give focus on the lives we save," she says. "We always think about the lives we lost and how to get better."
A JSS maternal and child health worker , or MCH, called Raj Kumari, similarly counted more than 75 clinic referrals for kids under five over the past two years. "This app has helped ensure I don't miss any questions. It's offline, so we don't need a phone network for it. Of course, not every frontline worker has an Android phone, so that is a limitation, but I use it every day. All of us with phones do."
One of those referral patients was Uma Jagath's baby, who developed flu-like symptoms last year. The app's 20 questions signalled suspected pneumonia Kumari, working closely with her government-employed Mitanin counterpart, Sumitra Yadav, sent the child to the nearest village sub-centre, where she was treated on the ward for three days before showing signs of improvement.
"Pneumonia impacts children from vulnerable backgrounds more often because of lack of nourishment, but we are able to repurpose this resource now to reduce deaths," says Dr Phutke. "With a simple digital breath counter and mobile technology, we can continue to scale up."
On March 21, 2024, the Federal Trade Commission (FTC) released its findings on grocery supply chain performance during the COVID-19 pandemic. In a new insight, Competition Economics Analyst Fred Ashton reviews the studys findings and discusses how its narrow scope and limited economic analysis yielded unsubstantiated conclusions that say little about the current state of competition in grocery supply chains.
Ashton concludes:
The FTCs study on the grocery supply chain during the COVID-19 pandemic concluded that corporations leveraged their size to entrench their market power at the expense of smaller rivals and that these firms used the inflationary environment to extract ill-gotten profits.
The study signals that the FTC may use these conclusions to revitalize Robinson-Patman Act enforcement, which would likely usher in higher prices for consumers while protecting inefficient competitors. Its methodology relied heavily on caveats and carveouts, and the resulting conclusions failed to measure the effects on competition broadly. The FTC should not rely on the findings as a guide to implement policy.
Read the analysis
In this study, we attempted to find an association between the serum aldosterone levels measured on days 1, 3, 5, and 7 and the overall survival in the intensive care unit (ICU) for a duration of 28days. Even though the mean plasma aldosterone levels were higher in the patients who did not survive for 28days, the results were not statistically significant, indicating that aldosterone is not associated with ICU mortality. A previous study by Villard et al.14 reported a worse disease course in patients with higher aldosterone levels at admission; specifically, those with higher plasma aldosterone levels were more likely to be admitted to the ICU. This might indicate that plasma aldosterone levels might be associated with the rate of admissions to ICUs but do not correlate with overall days survived in the ICU. Studies suggest that SARS-CoV-2, by competing with angiotensin II for the ACE2 receptor, indirectly increases Ang-II levels, which should increase aldosterone biosynthesis. It is possible that aldosterone production in COVID-19 patients increases with disease severity and reaches a peak when the state of the patient calls for an ICU admission. More research is needed to reach a definite conclusion.
Systemic inflammation evoked by SARS-CoV-2 is a hallmark of COVID-19, and one of the most widely used biomarkers for inflammation is an acute-phase protein CRP, which is biosynthesized in the liver in response to elevated interleukin-6 levels14,15. Interestingly, our results showed statistically significantly lower levels of serum CRP in patients who died during their 28-day stay in the ICU, yet it was not associated with higher mortality. This outcome contradicts previous findings indicating a relationship between CRP serum concentration and severity of the disease16,17,18,19,20. This discrepancy could be a result of the small size of the group that survived beyond 28days.
Higher serum creatinine levels have been shown to be another strong predictor of ICU admission and mortality21. Our study provides additional evidence that high serum creatinine concentration is a predictor of COVID-related ICU mortality; higher creatinine levels were observed on days 1, 3, and 5 in patients who died within 28days than in the group of individuals who survived. Many large studies, including meta-analyses, have confirmed the association of high creatinine levels with increased mortality in severely ill patients21,22,23.
In our study, univariate analysis showed increased mortality in the group of patients with higher APACHE II, SAPS II, and SOFA scores. Multivariate analysis showed that age (HR=1.03, p=0.033) was a robust predictor of mortality in the entire study population, similar to the finding of the meta-analysis by Kowsar et al.24. COVID-19 is a disease with a difficult-to-predict course. In intensive care units, numerous scales are routinely used to assess the risk of death and estimate the severity of the condition and organ function upon admission. Our study selected the most frequently used and valuable ICU scales. In a study by Monk et al., no advantage of any mortality scoring systems applied to COVID-19 was demonstrated. The study showed that SOFA, SAPS II, APACHE II, and ISARIC 4-C scores accurately predicted mortality in critically ill patients with COVID-19. The SOFA score executed the best. The study conducted by our team showed correlations of the values obtained in the SOFA, APACHE II, and SAPS II scales with mortality12.
Comorbidities associated with higher mortality following SARS-CoV-2 infection are hypertension and diabetes. There is a strong association between in-hospital mortality due to COVID-19 and hypertension, coronary heart disease, and diabetes25, although our study did not show a statistically significant effect of these factors on mortality. Researchers have postulated that the use of RAS blockers, such as ACE inhibitors or angiotensin receptor blockers (ARB), which are frequently administered in these conditions, might contribute to upregulation of ACE2, which could potentially promote cell entry of SARS-CoV-2, causing worse outcomes. The BRACE CORONA clinical trial later proved that neither continuation nor discontinuation of these drugs had a significant impact on mortality or COVID-19 progression26. Mineralocorticoid antagonists have also failed to show any effect on mortality in a recent meta-analysis27. The activation of RAAS by SARS-CoV-2 may lead to a direct increase in aldosterone production; one of the production sites may be the endothelial cells of the pulmonary vessels29. Higher levels of aldosterone may induce severe forms of COVID-19, especially in older patients, by promoting the inflammatory response and inducing electrolyte disorders such as hypokalemia.
One of the treatment options for COVID-19, in the case of high aldosterone concentration correlation with mortality, could be the use of mineralocorticosteroid receptor antagonists (MRAs). Reports on the effect of MRAs on COVID-19 are ambiguous22,28,29. MRAs, ACE inhibitors (ACE-I), and angiotensin receptor blockers (ARBs) were analyzed for their effects on COVID-19. Many patients discontinued RAASi treatment during the first phase of the COVID-19 pandemic due to the potential for these drugs to increase ACE 2 expression and levels. Numerous studies have shown that RAASi use is not linked to the risk of COVID-1928,29,30. Compared to ACE-I and ARBs, using MRAs in COVID-19 may provide some benefits. Additionally, MRAs, by stimulating ADAM metalloproteinase domain 17 protein, increases circulating ACE 2, which might bind SARS-CoV-2 as a competitive interceptor29. MRAs can suppress the expression of type II transmembrane serine protease TMPRSS2, which increases viral uptake of SARS-CoV-2 in target cells by promoting membrane fusion of Spike glycoprotein through a proteolytic cleavage between the S1 and S2 subunits and, also, by cleaving ACE 2 that, in turn, activates cathepsin L-dependent pathway31.
Inhibiting these pathways induced by MRAs could suppress or reduce viral entry in human cells. It might benefit COVID-19 infection and acute respiratory distress syndrome32,33. The reason why aldosterone levels were measured in our ward was to investigate the correlation of its level with mortality, which could potentially result in appropriate treatment. The result of our study did not justify the rationale for use of MRAs in the treatment of Covid-19 patients.
This study has certain limitations that need to be considered when interpreting the findings. First, this is a single-center study with a small simple size. Second, it is a retrospective, cross-selection study; thus, further prospective studies should verify the findings. Further, the chemiluminescent immunoassay method may not reveal aldosterone serum levels. Wiegand et al.34 demonstrated that aldosterone cannot be accurately estimated in serum from patients with SARS-CoV-2 infection using direct competitive immunoassay. When measured using gold-standard LCMSMS, serum aldosterone is found to be remarkably low in most patients with COVID-19. However, the chemiluminescent immunoassay method used for aldosterone determination in our study is a well-validated measurement method that is routinely used for aldosterone level determinations in laboratory practice. The method used in the study was compared with a manual radioimmunoassay (RIA), in accordance with the guidelines of CLSI EP9 (Clinical & Laboratory Standards InstituteMeasurement Procedure Comparison and Bias Estimation). The correlation coefficients were 0.98 (for serum) and 0.90 (for urine). In addition, this parameter is subject to monthly international control (RIQAS external quality control system run by Randox).
It's been four years since the world went into lockdown mode as COVID-19 rapidly spread across the globe. But a new book by political scientist Dali Yang dives into the information about, and mitigation of, the disease in its earliest days in China. In today's episode, Yang speaks with Here & Now's Scott Tong about the research that went into Wuhan, the way local governments and medical officials abstained from disclosing crucial intelligence in the early days, and the strict lockdown that followed.
To listen to Book of the Day sponsor-free and support NPR's book coverage, sign up for Book of the Day+ at plus.npr.org/bookoftheday
In the 2024 US elections, the topic of the COVID-19 pandemic has been almost entirely ignored by both major capitalist candidates, Joe Biden andDonald Trump, as well as almost every third party campaign. Only the Socialist Equality Party and its candidates Joseph Kishore and Jerry White have identified the pandemic as a significant ongoing issue and advanced a socialist program to stop it.
Contrary to the lies of the corporate media andpolitical establishment, the pandemic is ongoing, and COVID-19 continues to infect, kill and debilitate masses of people globally each day. There have now been over 28.5 million excess deaths attributable to the pandemic globally, including over 1.4 million in the US, while over 4,000 people continue to die each day globally due to COVID-19 or its myriad health impacts. Studies estimate that hundreds of millions of people throughout the world are now suffering from Long COVID, with their ranks swelling with each new wave of mass infection.
What accounts for the silence of all the capitalist and middle class parties on this world historic event that has impacted every human being and profoundly altered global society?
The pandemic, which began just over four years ago, was arguably the central issue in the 2020 US elections. The horrifying response of the Trump administration, which combined the most blatant pro-capitalist policies with extreme backwardness and hostility to science, shocked millions of Americans.
While Trump whipped up his fascist supporters to oppose limited lockdowns and all other basic public health measures, Biden claimed that he would follow the science and stop the pandemic. In the final debate in October 2020, when just over 200,000 Americans had died of COVID-19, Biden declared, Anyone whos responsible for that many deaths should not remain as president of the United States of America.
After winning the election, Biden immediately rejected lockdowns and initiated the full reopening of all public schools before any educators or children were even vaccinated. Since Bidens inauguration, over 720,000 Americans have died of COVID-19, the majority of the 1,186,671 total official deaths.
Bidens new CDC Director Rochelle Walensky proclaimed masks the Scarlet Letter of the pandemic and encouraged the lifting of mask mandates. After Biden prematurely declared independence from COVID-19 in July 2021, the CDC covered up the spread of the Delta variant and breakthrough infections.
The global spread of the Omicron variant in November 2021 prompted the Biden administration to fully embrace Trumps fascistic herd immunity program, steadily abandoning all public health measures and allowing the virus to spread unchecked. Promoting eugenicist conceptions, in January 2022 Walensky deemed it encouraging news that COVID-19 predominantly kills people who are unwell to begin with.
The normalization of the pandemic culminated in the scrapping of the COVID-19 public health emergency (PHE) declaration in May 2023. This led to the dismantling of all pandemic surveillance and mass disenrollment from Medicaid, withover 19 million Americanslosing access to healthcare over the past year.
The Biden administration now completely ignores the ongoing dangers of the pandemic, including the growing ranks of those suffering from Long COVID and the ever-present threat of a far more dangerous variant evolving due to unchecked viral transmission. The official narrative is that COVID-19 has become endemic and essentially harmless. This delusional fantasy, parroted by the entire corporate media, underpins the Biden administrations approach to the pandemic in the 2024 elections.
As part of his Make America Great Again mythology, Trump has sought to portray his presidency as a Golden Age in US history, covering up his own disastrous response during the first year of the pandemic.
Only in the past couple weeks has Joe Biden begun to raise the pandemic at campaign events, making cheap jokes about Trumps most extreme anti-science statements about treating COVID-19 through injecting disinfectants or ultraviolet light. But Bidens record stands as a devastating indictment of the Democratic Party, which is equally culpable in the mass death and debilitation of the American population.
Outside the major capitalist parties, the positions of the leading third party candidates range from far-right anti-vaccine propaganda to complete silence on the pandemic.
The standard bearer for the most unhinged and reactionary anti-science politics is Robert F. Kennedy Jr. A member of the Disinformation Dozen responsible for the majority of anti-vaccine disinformation on social media during the pandemic, for decades he has been a leading purveyor of false claims that vaccines cause autism and other developmental disorders among children.
During the pandemic, RFK Jr. took this propaganda to a new level, organizing numerous rallies to oppose vaccine mandates and other basic public health measures required to stop the spread of COVID-19. Along with large sections of the political establishment and corporate media, he has also promoted the Wuhan Lab conspiracy theory, which aims to foment anti-Chinese racism and prepare the grounds for direct military confrontation with China.
The next leading third party candidate, Cornel West, has adopted a thoroughly reactionary policy on vaccines and adapted himself to the right-wing campaign against scientists and science. On his campaign website, West lists as one of his demands, Convene a federal panel of scientists and experts to study the safety and utilization of vaccines for infectious diseases.
What cynicism and cowardice! Will Wests panel review the safety of the decades-old vaccines for chicken pox, influenza, measles, mumps and rubella and others? Will they go back and review the safety of the vaccine which successfully eradicated smallpox in 1980? West advances this position under conditions in which measles is spreading across the US due to declining vaccination rates, an expression of social backwardness to which he is appealing. To revive a phrase from the 1960s, West is not part of the solution, he is part of the problem.
In an interview with far-right comedian Jimmy Dore last September, West stated, I think the kind of concerns that you and RFK Jr. and others have certainly are well-grounded. Asked whether he agreed with a right-wingDecember 13, 2021, statementfrom the National Black Caucus of the Green Party that denounced the partys support for vaccine mandates and passports, West stated, If I had another chance, Id be leaning much more with the Black Caucus.
Mehring Books
COVID, Capitalism, and Class War: A Social and Political Chronology of the Pandemic
A compilation of the World Socialist Web Site's coverage of this global crisis, available in epub and print formats.
After West withdrew from the Green Party race to run as an independent, Jill Stein launched her presidential campaign last November, two months after Wests interview with Dore. She has never commented on this interview, and her campaign website entirely omits the pandemic.
In an interview with Kim Iversen, Stein was asked the same question as West about the Green Partys position on vaccine mandates. Distancing herself from this and appealing to anti-vaccine sentiment, Stein said, Mandates are not workable, and they can be wrong, and in some ways they were wrong. She also intimated her support for the Wuhan Lab Lie, stating, The whole issue of where did COVID come from has not been addressed and must be addressed.
Despite being a Harvard-educated physician, before the pandemic Stein repeatedly used anti-vaccine rhetoric, including the promotion of baseless claims about mercury poisoning from vaccines.
The campaign of the Party for Socialism and Liberation (PSL), a Stalinist party which split from the Workers World Party (WWP) in 2004, has also largely ignored the pandemic. Their campaign website only briefly refers to the pandemic in the past tense, and a video on the pandemic released by the PSLs presidential candidate, Claudia de la Cruz, was widely denounced by anti-COVID advocates. The PSL quickly deleted the video without comment, and since then has resumed their de facto policy of simply ignoring the pandemic.
The only candidates who have placed the pandemic as a central theme of their campaign are Joseph Kishore and Jerry White, who have advanced a scientifically-grounded socialist public health program. In numerous statements and videos posted on social media, both candidates have advocated for masking, while stressing that this must be combined with a broader strategy aimed at eliminating COVID-19 globally.
In a campaign statement posted on Long COVID Awareness Day, March 15, Kishore wrote:
The Socialist Equality Party (SEP) and our election campaign insist that elimination remains both viable and necessary. We advance a globally-coordinated elimination strategy, in which the entire worlds population acts in solidarity and with a collective determination to enforce a broad-based public health program.
Such a strategy includes mass testing, contact tracing, the safe isolation and treatment of all infected patients, the universal use of high-quality masks, and the renovation of all public buildings to provide clean indoor air through HEPA filters and the safe implementation of Far-UVC devices. There must be a vast expansion in funding for Long COVID research and a systematic program of scientific education.
After four years of the pandemic, however, it is abundantly clear that such a strategy will never arise under world capitalism, which subordinates all public health spending to the insatiable profit interests of a money-mad financial oligarchy. It can only be implemented through a turn to the working class and the building of a mass movement fighting to restructure society on the basis of social need, not private profit.
The response of different political tendencies to the pandemic makes clear who are the genuine socialists and whose program represents the interests of the international working class. Despite the efforts of the media and official politics to cover up the pandemic, its devastating and ongoing toll will continue to affect mass consciousness and contribute to the deepening political radicalization of the international working class. This opposition must be unified on a world scale and aimed at the socialist overturn of the decaying capitalist system.
Join the fight to end the COVID-19 pandemic
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Elderly hands on a mobility walker.
People born recently in England and Wales can expect to spend fewer years of their life in good health than those born over a decade ago, official figures show.
Covid-19, healthcare delays and an increase in long-term sickness are likely factors in this decline. But the Office of National Statistics figures also reflect deeper social issues like widespread inequality, say experts.
Men born in England from 2020 to 2022 can expect to spend between 62.4 years of their life in good health 9.3 months less than those born from 2011 to 2013.
Women in England can expect to live 62.7 years in good health, which is a drop of 1.5 years in just over a decade.
Wales had the lowest average HLE at 61.1 years for men and just 60.3 years for women.
Men in Northern Ireland saw their HLE increase by more than a year compared to 2011-2013, while women saw theirs fall by 15.3 months.
Women saw the biggest decrease in healthy life expectency across the U.K., with Wales, Northern Ireland and every region of England seeing a decline.
Scotland was not included in the analysis, as figures from its most recent census are not yet available.
The overall drop in HLE is likely driven in part by Covid-19, as there had been minimal change in healthy life expectancy up to 201719, according to Veena Raleigh, senior fellow at health think thank The Kings Fund.
Healthcare delays and a rise in long-term sickness after the pandemic have probably also played a role she added in a statement.
The U.K.s health care system has been struggling to catch up on surgery backlogs that grew sharply during the pandemic. Already on the rise before Covid-19, the number of patients in England waiting for an elective procedure was around 7.58 million in January.
The amount of time people can expect to live healthily differs markedly across the country, the ONS figures show.
A stark north-south divide, Raleigh said, is the product of deep-seated socio-economic inequalities between different communities.
The north of England falls behind than the south on numerous measures including wages, public investment and overall life expectancy. The divide is a frequent target for lawmakers, who have set up projects like the Northern Powerhouse to invest in the region.
The impact of initiatives like these have long come under question, with substantial divisions still clear across the country.
The new HLE statistics lay bare the wide geographical inequalities in England, with healthy life expectancy in the north east being almost seven years shorter for males and six years shorter for females compared with the south east, Raleigh said.
The state of child and adult health in England is poor and declining, she added, which has a devastating impact on individuals, families and communities, and results in significant costs to society and the economy.
Bolder action was needed to help people live longer and healthier lives, she said. And this should be seen by the government as a sound investment and urgent priority, not just as another demand on the public exchequer.
A recent study published in Nature Communications explored the association of COVID-19 with long-term allergic conditions.
Study:Incident allergic diseases in post-COVID-19 condition: multinational cohort studies from South Korea, Japan and the UK. Image Credit:wavebreakmedia/Shutterstock.com
The severe respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in late 2019, and led to the declaration of a coronavirus disease 2019 (COVID-19) pandemic in March 2020. It caused over seven million deaths and many times that number of infections and hospitalizations.
Additionally, nearly half of COVID-19 cases have to deal with delayed or chronic morbidity, which may have set in during or after the acute phase of infection. These are called post-COVID-19 conditions or post-acute sequelae of COVID-19 (PASC), otherwise known as long COVID.
Symptoms of PASC, in some cases, include immunologic phenomena that may cause allergic conditions of various kinds.
The study aimed to investigate how ethnicity affects allergic conditions following COVID-19. Researchers formed a synthetic group comprising over 22 million individuals from South Korea, Japan, and the UK, drawing participants from multinational studies to represent these ethnic backgrounds. S
pecifically, the South Korean segment included more than 800,000 people with an average age of 48. From the UK and Japan, the cohorts included over 325,000 and 2.5 million participants, respectively.
Within these groups, approximately 150,000 participants from South Korea, 77,000 from the UK, and 542,000 from Japan had been infected with SARS-CoV-2. This large-scale analysis aimed to shed light on the ethnic variations in post-COVID-19 allergic reactions.
After adjusting for all known variables that could affect the outcome, the researchers discovered that individuals infected with SARS-CoV-2 showed a 20% higher occurrence of allergic diseases compared to those not infected.
This increased risk was consistent for infections from both the original and Delta variants of the virus. Specifically, the likelihood of developing asthma in those infected was more than double, at 2.25 times that in non-infected individuals.
The chance of getting allergic rhinitis was 25% higher in the infected group, though no significant increase was observed for food allergies or atopic dermatitis.
Moreover, while the risk for allergic diseases decreased over time after the infection, it didn't disappear entirely. This decrease in risk varied from country to country.
Moderate-to-severe COVID-19 was linked to a 50% higher risk of overall allergy, compared to 14% among those with mild disease.
Those who had received the vaccine had a 44% higher risk of allergy (with one dose). This was reduced by 20% after two doses of the vaccine. The two-dose cohort had comparable allergy risk as the controls, both overall and for the various allergy subgroups.
Other factors like coexisting morbidity, drinking, body mass index, exercise, and the SARS-CoV-2 strain responsible for the infection, did not show significant correlation with allergy risk.
This is the first study that provides comprehensive evidence for the association between SARS-CoV-2 infection and subsequent incident allergic outcomes.
It emphasizes the relationship between COVID-19, especially moderate to severe, and subsequent allergy onset. It also indicates that COVID-19 vaccination with at least two doses weakens the risk of new allergies.
The findings broadly corroborate earlier research, but there is a need for more studies on the allergic sequelae of COVID-19 on a larger and more multinational scale.
Multiple pathways have been proposed to account for the observed correlations, including T cell disruption, regulatory T cell (Treg) disturbances, and the cytokine storm in acute severe COVID-19.
Over time, the virus may be slowly cleared from the host, especially if adaptive immunity has been strengthened by vaccination against the virus.
The study underlines a need for persistent health policies to manage the severity of SARS-CoV-2 infection. People with a history of COVID-19 should be aware that they are at higher risk for allergic manifestations in the short-term future, at least.
Journal reference:
Oh, J., Lee, M., Kim, M., et al. Incident allergic diseases in post-COVID-19 condition: multinational cohort studies from South Korea, Japan and the UK. Nature Communications. doi: https://doi.org/10.1038/s41467-024-47176-w.
The global life expectancy fell by 1.6 years during the pandemic but Australia is one of 32 countries to record an increase.
Users of a particular COVID-19 test have been warned to take faint lines seriously in a notice from the Therapeutic Goods Administration.
The TGA said the makers of Fanttest COVID-19 test kits had been made aware of the potential for the kit to display positive test lines of varying faintness.
Users are warned that a faint line appearing in the "control" (C) section is still an indication of a strong positive test for the virus.
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"The Instructions for Use (IFU) state that a valid result occurs when a coloured line appears in the control region (C)," the TGA said in its online notice.
"There is no mention that there is potential for variability in the appearance of the control line.
"However, where strong COVID-19 positive results are obtained there is potential for a faintly appearing control line.
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"This has caused customer confusion and possible misinterpretation that the test result is invalid when it is actually a valid positive result."
The TGA said the manufacturer had updated the IFU for batches manufactured after February 2024 to include information about the potentially faint appearance of the control line.
