A lab in West Virginia University Hospitals Health Sciences Building has temporarily closed following the discovery of asbestos in dust.
WVU Hospitals risk management and safety director Roger Osbourn tells The Dominion Postthat the asbestos is an isolated incident. He says it most likely resulted when a pipe was bumped during renovations on the floor above the lab.
University environmental health and safety director John Principe says tests showed trace amounts of asbestos fibers. Air sample tests were negative.
Researchers have made significant progress in understanding the impact of the COVID-19 virus on dermatologic conditions, including hair loss, pemphigus, urticaria, and rare diseases.Recent studies have shed light on the potential associations and manifestations post-COVID-19 infection or vaccination.
This week,Dermatology Timesis highlighting recent COVID-19 research affecting skin, hair, and nailsin recognition of 4 years since the start of the pandemic.
One study investigated the relationship between COVID-19 and telogen effluvium (TE) in Saudi Arabia. Conducted through a cross-sectional design from March to September 2022, it involved 392 participants with confirmed COVID-19 infections. Data were collected via online questionnaires. Results indicated that hair shedding post-COVID-19 affected 60% of participants, with various onset times and durations. Women with a history of TE and antiviral treatment for COVID-19 were identified as having more significant risks for hair shedding. Limitations of the study included lack of clinical evaluation by dermatologists. The study emphasized the importance of recognizing COVID-19-related hair shedding and highlighted the need for further objective assessment studies. It aimed to contribute to medical literature on COVID-19, urging healthcare providers to be vigilant and considerate of potential cutaneous manifestations in patients. The study proposed future research to explore the association between COVID-19 and chronic TE and suggested enhanced clinical evaluation methods for a more precise understanding.1
Various cutaneous reactions have been reported following COVID-19 vaccination globally. A registry-based study highlighted delayed large local reactions as the most common, with mRNA vaccines showing distinct reactions compared to viral vector vaccines. Three cases of pityriasis rosea (PR) and PR-like eruptions following COVID-19 vaccination were described in Oman Medical Journal. Two patients received Pfizer-BioNTech mRNA vaccines, while the third received the Oxford-AstraZeneca viral vector vaccine.2
Case 1 involved a 19-year-old male presenting with PR-like eruption after the first dose of Pfizer-BioNTech vaccine. Case2was a woman experiencing PR after the first Pfizer-BioNTech dose, with a milder recurrence post-second dose. Case 3, a man in his seventies, developed PR-like eruption following the second dose of Oxford-AstraZeneca vaccine.Cutaneous reactions post-COVID-19 vaccination are diverse, including PR and PR-like eruptions. These reactions can occur with both mRNA and viral vector vaccines. Mechanisms may involve immune dysregulation and viral reactivation. Diagnosis and management rely on clinical presentation and histopathological examination. PR and PR-like eruptions post-COVID-19 vaccination are rare but possible. Vigilance in monitoring skin reactions following vaccination is crucial. Further studies are needed to understand the relationship between vaccination and cutaneous reactions, especially regarding viral reactivation.
Despite documented safety profiles of COVID-19 vaccines, vaccine hesitancy persists among individuals with immune-mediated inflammatory diseases (IMIDs), especially due to limited data on long-term safety. This study aimed to assess delayed adverse events (DAEs) occurring over seven days post-vaccination in systemic lupus erythematosus (SLE) and other rheumatic and non-rheumatic autoimmune diseases (rAIDs and nrAIDs) compared to healthy controls (HCs). Data were collected via the COVAD-2 online survey from over 150 centers in 106 countries between February and June 2022. Logistic regression analysis, adjusting for confounders, compared adverse events among groups.3
Among 7203 participants, SLE patients reported higher rates of major DAEs and hospitalizations compared to HCs. They also experienced more severe rashes compared to individuals with rAIDs and higher hospitalization rates compared to those with nrAIDs. Differences in adverse events were observed between vaccine types, with Moderna recipients experiencing more hospitalizations. SLE patients without autoimmune multimorbidity reported fewer minor DAEs compared to those with comorbid nrAIDs.SLE patients had a higher risk of hospitalization post-vaccination compared to HCs. Close monitoring of SLE patients post-vaccination can aid in early detection of adverse events, informing patients, especially those with multiple autoimmune conditions, and providing necessary support.
The study presents a case of a 73-year-old woman developing pemphigus 2 weeks after contracting COVID-19, shedding light on the limited data regarding pemphigus incidence post-COVID-19 infection. The patient presented with blistering eruptions on multiple body parts post-COVID-19 diagnosis, prompting further investigation. Biopsies indicatedfeatures of pemphigus vulgaris (PV) and paraneoplastic pemphigus (PNP), with subsequent negative malignancy findings. Treatment with prednisone and mycophenolate mofetil led to complete remission at 9 months follow-up.4
COVID-19 has been linked to autoimmune diseases, possibly through molecular mimicry and immune dysregulation mechanisms. Reports suggest a time lag between COVID-19 and pemphigus onset, possibly due to aberrant immune responses triggered by the virus. Interestingly, the patient exhibited features of both PV and PNP, suggesting a complex autoimmune response influenced by COVID-19. This case underscores the need for vigilance regarding autoimmune manifestations post-COVID-19.
During the COVID-19 pandemic, the widespread use of face masks has led to an increase in dermatoses, including reports of Koebner phenomenon, especially in patients with psoriasis. However, there has been limited documentation of mask-induced pemphigus lesions. This study presented 2 cases of patients with pemphigus developing new or persistent lesions on their noses, the area most irritated by mask usage.The first case involved a 56-year-old man with pemphigus vegetans, who developed nasal lesions four months after the pandemic began, coinciding with increased mask usage. Treatment with oral methylprednisolone and azathioprine resulted in mild improvement. The second case was a 47-year-old man with pemphigus vulgaris, exhibiting erosive lesions on the nose and oral mucosa, exacerbated by prolonged mask wearing. Despite treatment, nasal lesions persisted, indicating a possible mask-induced Koebner phenomenon.5
While previous reports linked pemphigus lesions to trauma or light exposure, the consistent occurrence of nasal lesions in these cases highlights the role of mask-related minor traumas. Despite being rare, the potential for Koebner phenomenon in pemphigus patients necessitates consideration, especially amidst pandemic conditions with widespread mask usage.
This retrospective study analyzed data from the Cosmos database to investigate the incidence and mortality of Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) in patients with COVID-19. Among 10,675,070 patients diagnosed with COVID-19, 270 developed SJS/TEN within 8 weeks. The mean age was 50, with 54% female, and most were White (70%). The incidence of SJS/TEN was twice as high in COVID-19 patients compared to those without (2.5 vs. 1.2 cases per 100,000 individuals, p < .001). The 8-week mortality rate among SJS/TEN patients with COVID-19 was significantly higher than in those without (8.5% vs. 6.8%, p < .001).6
The study suggested a link between COVID-19 infection and increased risk of SJS/TEN, possibly due to virus-induced drug hypersensitivity. Antibiotic use in COVID-19 treatment may contribute, as many implicated antibiotics are commonly prescribed. However, further research is needed to understand the underlying mechanisms fully.
Research published in the Indian Dermatology Online Journal suggested a potential link to pyoderma gangrenosum (PG). This study presented 3 cases of PG on the breast, discussing the overlapping inflammatory cytokine profiles seen in PG and COVID-19. Increased pro-inflammatory cytokines observed in both PG and COVID-19, including TNF-, IL-1, IL-6, and IL-8, suggest a possible connection. COVID-19 vaccination can trigger autoimmunity and hyperinflammation, similar to mechanisms seen in PG pathogenesis. However, no reported cases of PG on the breast have been linked directly to COVID-19 infection or vaccination.7
While surgical interventions precede many cases of breast PG, none of the reported cases occurred post-COVID-19 infection or vaccination. Although PG may independently associate with COVID-19, further research is needed to confirm this connection conclusively. Investigators suggested that patients with dysregulated immune systems, including those vaccinated for COVID-19, should undergo extended follow-up for potential PG development. Monitoring for PG, even in non-vaccination sites, is crucial as it could exacerbate COVID-19 severity.
Earlier this year, the JAAD Case Report featured 7 patients developed chronic urticaria (CU) following mRNA-1273 COVID-19 booster vaccination. The median onset of urticaria was 11 days post-vaccination, lasting up to 16 months in some cases. While most patients were treated with antihistamines, symptom resolution occurred in only three cases. Notably, 2 patients received BNT162b2b (Pfizer-BioNTech) booster without exacerbating CU, suggesting a potential approach for future vaccinations.8
Although causation between COVID-19 vaccines and CU remains uncertain, previous literature suggests a correlation, with Moderna vaccines more frequently linked to delayed-onset CU compared to Pfizer. However, most patients tolerated subsequent vaccinations well, emphasizing the importance of shared decision-making regarding future doses. While the retrospective nature of this report limits definitive conclusions, the ability of some patients to tolerate alternative vaccineswarrants consideration in vaccine discussions. However, the necessity of such changesremains unclear, requiring further study. This case series contributes to understanding cutaneous reactions to COVID-19 vaccines and highlights the need for ongoing vigilance and research in this area.
References
In a cohort study comparing veterans diagnosed with COVID-19 with those not diagnosed, all participants reported a substantial loss of day-to-day functioning.1
The World Health Organizations clinical case definition of post COVID-19 condition specifies that an impact on everyday functioning is essential to the diagnosis. However, many studies describing the high burden of symptoms and accumulation of new diagnoses following COVID-19 infection have failed to capture function, wrote authors of the study.
Post COVID-19 condition, more commonly known as long COVID, is when an individuals symptoms persist, or new symptoms arise, 3 months after an initial COVID-19 diagnosis.2
Researchers aimed to compare the daily functions of veterans both infected and not infected by COVID-19 starting 18 months after self-reporting their diagnosis. When they reported their infection, researchers quickly found a comparator participant without COVID-19 to secure the closest match to the infected individual.1
Participants were sent a survey to record levels of pain, fatigue, activities of daily living, mobility, and overall quality of life. Results of this study were published in the JAMA Network Open.1
Using data from the United States Veterans Affairs (VA), 186 veterans who tested positive for COVID-19 were included in the study (mean age 60.4; 90.4% men). They were then matched with the exact number of comparators (mean age 61.1; 90.4% men), totaling 372 participants in the entire sample.
Older veteran saluting | image credit: Lydia - stock.adobe.com
In this cohort study, veterans reported high rates of ongoing fatigue, pain, and disability after the COVID-19 pandemic, regardless of history of COVID-19. There were no statistically significant results between these symptoms and COVID-19 illness, wrote the authors.
Indeed, results of the survey were staggered and there was no correlation to COVID-19 infection and reduced daily functioning.1
Regarding daily activities, veterans with COVID-19 reported a mean of 3.4 limitations and 37.3% reported 4 or more limitations. Their matched comparators reported a mean of just 3 limitations and 30.2% reported 4 or more limitations.1
However, of veterans diagnosed with COVID-19, just 51.1% reported moderate, severe, or extreme pain 18 months after infection, compared with 65.7% of those not infected.1
Participants were also asked about their overall quality of life on a scale of 1 to 100; the higher the score, the closer they were to the everyday functionality experienced prior to the pandemic in 2020.
Of the veterans in the COVID-19 cohort, 44.9% reported they could do less than 75% of what they felt they could do at the beginning of 2020, in contrast with 35.3% of their comparators, wrote the authors.
READ MORE: Vaccines to Watch in 2024
Reporting that there were no statistically significant results observed in the study, researchers concluded that the pandemic as a whole, whether individuals were infected with COVID-19 or not, had adverse effects on the population.
These data are consistent with an interpretation that the COVID-19 pandemic has had adverse effects outside of solely infectious or post-infectious mechanisms, wrote the authors.1 Other adverse effects may have been due to psychological, behavioral, social, policy, and economic mechanisms.
While researchers did not find a significant difference between veterans infected and their comparator cohort, they were still sure to point out study limitations and the need for further research on the effects of long COVID.
Since all data came from the VA with just 2 cohorts of 186 participants, researchers stated that the results should not be generalized to the population. They also mentioned that a greater sample size could assess differences in sex since the studys female population was just 9.6% in both cohorts.
These data cannot rule out the possibility that COVID-19-confirmed viral infection may be associated with disability among some individuals who had COVID-19, they continued.1
Researchers concluded the study by identifying the need for more research on both post-COVID-19 condition and the non-physical burdens associated with the pandemic.
Future work with larger samples is needed to validate the estimated associations, the authors concluded.1
READ MORE: Disparities in Digital Health Portal Use Persist Beyond the COVID-19 Pandemic
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CHARLESTON, W.Va.The West Virginia Department of Health (DH) is informing all West Virginians ages 65 and older they are eligible for an additional dose of the updated COVID-19 vaccine, following the Centers for Disease Control and Preventions (CDC) recentrecommendation.
As the data consistently shows, those who are older and immunocompromised are the most vulnerable to the severe effects of COVID-19, said Secretary Sherri Young, DO, MBA, FAAFP. It is for this reason we encourage those individuals to strongly consider getting an additional dose.
West Virginias Pan Respiratory Dashboardshows only 36 percent of West Virginians over the age of 61 are up-to-date on COVID-19 vaccines. The dashboard shows that more than a hundred West Virginians died from COVID-19 in the last year, with the average age of those individuals being 73.
Under current recommendations, those 65 and older can receive an additional dose of the vaccine at least four months after the previous shot. The updated vaccine targets both the original strain of the virus and newer variants, offering broader protection.
To find updated COVID-19 information and the nearest vaccination location, visitCOVID-19 Vaccine (wv.gov).
The West Virginia Department of Health (DH) seeks to advance the health and well-being of all West Virginians promoting healthy behaviors, working to mitigate public health crises, and increasing access to health-related resources and information.
A study by Oregon Health & Science University shows that COVID-19 vaccination timing can slightly and temporarily alter menstrual cycle length, especially when given in the cycles first half. These findings aim to reassure and inform about minor changes, highlighting the need for more research on menstruations significance for health and fertility.
Researchers at Oregon Health & Science University have confirmed a link between the timing of COVID-19 vaccination and slight, temporary changes in the length of menstrual cycles.
The study, published in the journal Obstetrics & Gynecology, found that individuals receiving a COVID-19 vaccine during the first half of their menstrual cycle are more likely to experience cycle length changes than those receiving a vaccine in the second half.
Building on prior work from the same research team that first identified an association between COVID-19 vaccines and menstrual cycle length, this study furthers understanding of how the timing of vaccination is associated with this change.
Understanding these changes on a population level allows us to more effectively counsel patients about what to expect with a COVID-19 vaccine, said Alison Edelman, M.D., M.P.H., the studys lead author and professor of obstetrics and gynecology and division director of Complex Family Planning in the OHSU School of Medicine. We hope this work helps validate the publics experiences and ease fears and anxiety around vaccination.
With data from nearly 20,000 users of the FDA-cleared birth control application Natural Cycles, researchers sought to determine whether the timing of COVID-19 vaccination is associated with changes in menstrual cycle length. Individuals in the cohort analysis granted researchers permission to use their de-identified data.
Researchers compared three groups: individuals vaccinated in the follicular phase, the first phase of the menstrual cycle when the body collects follicles, or small sacs that have the potential to release an egg for fertilization during ovulation; individuals vaccinated in the luteal phase, the second part of the menstrual cycle starting after ovulation; and an unvaccinated control group.
Analysis shows that individuals who were vaccinated in the follicular phase experienced, on average, a one-day increase in cycle length when compared with their pre-vaccination cycle average. Changes typically resolved in the cycle after vaccination.
While there is now a large body of evidence demonstrating that the COVID-19 vaccine is associated with temporary menstrual cycle disturbances, the exact biological mechanism for these changes is still unknown.
We are constantly learning about how our bodies work together, but we do know the immune and reproductive systems interact closely with one another, Edelman explained. Based on this relationship, it is certainly plausible that individuals may see temporary changes in their menstrual cycle due to the immune response that vaccines are designed to produce.
Experiencing an unexpected change in menstrual cycles can be alarming. Researchers emphasize that these findings shouldnt be a cause for concern, but should provide reassurance that, if changes in cycle length occur with vaccination, they are likely to be small and temporary. Individuals who notice prolonged changes in menstruation are encouraged to seek guidance from their clinician.
Since the studys data were gathered from individuals with regular menstrual cycles pre-vaccine, the team emphasizes that additional research is needed to establish whether observed differences vary in some people who experience irregularities in their cycle. Additionally, researchers hope to better understand how other aspects of the menstrual cycle are affected by vaccination, such as menstrual-related symptoms and menstrual flow.
Historically, menstruation has not been prioritized in scientific and medical research, which leaves individuals who menstruate with a lot of unanswered questions, especially when they are experiencing something thats not normal for their body, Edelman said. Menstruation is a key indicator of fertility and overall health, so understanding these changes is very important to us as reproductive health researchers and to our patients.
Reference: Timing of Coronavirus Disease 2019 (COVID-19) Vaccination and Effects on Menstrual Cycle Changes by Alison Edelman, Emily R. Boniface, Victoria Male, Sharon Cameron, Eleonora Benhar, Leo Han, Kristen A. Matteson, Agathe van Lamsweerde, Jack T. Pearson and Blair G. Darney, 27 February 2024, Obstetrics and Gynecology. DOI: 10.1097/AOG.0000000000005550
Research reported in this publication was funded by the National Institutes of Healths Eunice Kennedy Shriver National Institute of Child Health and Human Development and Office of Research on Womens Health under award number HD089957.
HONOLULU (KHON2) When it was launched in September 2020, the COVID-19 dashboard was the central data source for tracking the virus across the state.
Check out whats going on around the nation on our National News page
It also showed the virus impact on the hospitals and even the number of personal protection equipment available.
Currently, the website is used to keep count of the reported cases of COVID-19 and is updated weekly.
We track these statistics on a daily basis, and it helps us allocate resources, we share this information with the leadership within our entire healthcare delivery system, not only hospitals, long-term care, home care, hospitals, said Hilton Raethel, Health Care Association of Hawaii, President and CEO.
The Hawaii State Department of Health is aligning its health avisements with the CDC guidelines but still plans to continue to use the dashboard with more than just COVID-19 data.
Our decisions are informed by what we put in those dashboards and what were seeing happening locally, explained State Epidemiologist Dr. Sarah Kemble.
So, I do think its really important that we continue to provide updated information to the public about whats happening COVID but also other respiratory diseases like not just COVID but RSV respiratory syncytial virus, influenza.
Federal money was used to create the site and the health department plans to continue using federal funding for the next two years to maintain the dashboard but develop an additional dashboard to keep track of overall respiratory disease activity in Hawaii.
Were really looking at how can we make updates to those dashboards to give that kind of broader information to people can make informed choices about how to protect themselves, said Kemble.
Raethel agreed stating that having more visibility into that is very helpful from a public health perspective and also from a treatment perspective.
The Department of Health hopes to publish the updated site next month.
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Prescribing PrEP: Its Easy as 1, 2, 3 KFF PrEP, prescribing PrEP, motivation, PrEP follow-up, no prior training, infectious disease doctor, HIV doctor In this video, Dr. Demetre Daskalakis explains to providers that if they are able to prescribe any medicine, they can prescribe PrEP. No pri
Prescribing PrEP: Its Easy as 1, 2, 3 KFF PrEP, prescribing PrEP, motivation, PrEP follow-up, no prior training, infectious disease doctor, HIV doctor In this video, Dr. Demetre Daskalakis explains to providers that if they are able to prescribe any medicine, they can prescribe PrEP. No pri
