Capital Region researchers awarded $3.9 million dollar grant to study long-COVID19
by Emani Payne
Long Covid Research (WRGB)
While the COVID-19 pandemic and the virus in general may seem like a thing of the past for many, its never left the minds of millions of Americans who are still struggling with long covid every day.
Its a far-reaching problem that Albany Medical College Professor Dr. Ariel Jaitovich and his team of researchers are working to better identify and understand.
Those lingering symptoms including things like shortness of breath, loss of smell and brain fog, are now identified as long covid.
Dr. Jaitovich and his team were recently awarded a 3.9 million dollar grant from the National Institutues of Health (NIH) to study long covid.
We havent been able to identify a blood test that can specifically make the diagnosis of long covid. We are conducting a study that is intended to identify substances in the blood called biomarkers in lab tests that can define objectively that a patient has long covid, said Jaitovich.
The team is also working to develop a way to better monitor disease progress, to more clearly identify if a patient is improving or getting worse. The study, which is still in its early stages, has already recruited hundreds of participants, desperate to find relief.
Saying this work is just the first step in hopefully one day slowing the virus down for good.
"Its extraordinarily difficult to investigate this disease on a large scale and without investigating the disease, its very difficult to understand it and potentially cure it," said Jaitovich.
The team is also partnering up with scientists at the University of Wisconsin on this research.
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CLEVELAND, Ohio The number of new COVID-19 cases in Ohio continued a downward trend for the fifth week, from 7,468 last week to 7,197 this week.
In early January, weekly case numbers hit 15,046.
At least 1,275,978 Ohioans have received the updated one-dose COVID-19 vaccine, an increase of 11,638 people from the prior week, the state reported. This represents 10.9% of the states population.
The total COVID-19 case count since early 2020 in Ohio has reached 3,705,349.
There were 236 Ohioans newly hospitalized in the last week, raising the total since the beginning of the pandemic in 2020 to 149,643. There were 12 people admitted into the ICU, bringing the total since 2020 to 15,722.
There were also 91 Ohioans who died from COVID-19-related issues, raising the total since the beginning of the pandemic to 43,608. Death reporting sometimes lags by weeks.
Feb. 8 recap
* Total reported cases: 3,705,349, up 7,197.
* Total individuals with updated vaccine: 1,275,978, up 11,638.
* Total reported deaths: 43,608, up 91.
* Total reported hospitalizations: 149,643, up 236.
* Total reported ICU admissions: 15,722, up 12.
Feb. 1 recap
* Total reported cases: 3,698,152, up 7,468.
* Total individuals with updated vaccine: 1,264,340, up 14,589.
* Total reported deaths: 43,517, up 73.
* Total reported hospitalizations: 149,407, up 247.
* Total reported ICU admissions: 15,710, up 13.
Julie Washington covers healthcare for cleveland.com. Read previous stories at this link.
Japanese researchers studying functional decline among patients aged 80 years and older hospitalized for SARS-CoV-2 Omicron pneumonia find significantly higher rates of decline in those also infected with bacteria than in those with primary viral pneumonia 1 year later, though both groups had substantial levels of impairment.
The study, published yesterday in Influenza and Other Respiratory Viruses, was conducted at five Japanese hospitals and clinics from December 2021 to August 2022. Attending physicians calculated the difference in activities-of-daily-living (ADL) scores from hospital admission to release.
"During the period when the ancestral [SARS-CoV-2] strain, Alpha variant, and Delta variant were dominant, bacterial coinfection and secondary bacterial infection in patients with COVID-19 were low," the study authors wrote. "In the Omicron period, however, the pattern of pneumonia changed from primarily viral pneumonia to pneumonia mixed with bacteria, mainly aspiration pneumonia."
Of the 891 patients with pneumonia due to the SARS-CoV-2 Omicron variant, 303 had primary viral pneumonia and 326 patients had pneumonia mixed with bacteria (primarily aspiration pneumonia).
Among patients with primary viral pneumonia, 112 cases were sequenced as the Omicron BA.1 subvariant, 70 were BA.2, and 121 cases were BA.5. Among patients with pneumonia mixed with bacteria, 118 cases were caused by Omicron BA.1, 72 were BA.2, and 136 were BA.5.The proportion of subvariants and vaccination status was the same between the two groups.
Functional decline rates at hospital release were significantly higher in patients with primary viral pneumonia than in those with pneumonia mixed with bacteria (52.3% vs 40.3%).
It is necessary to consider early rehabilitation and treatment in elderly patients even when the predominant strain is the Omicron variant.
But by 1 year, 139 of 171 (81.3%) patients with pneumonia mixed with bacteria who experienced reduced physical function at hospital release still showed functional decline. In comparison, 20.5% of patients with primary viral pneumonia had functional decline at 1 year. Among the Omicron subvariant groups, functional decline rates at hospital release and 1year later were similar in both pneumonia groups.
The researchers noted thatthe bacterial-coinfection group had higher rates of cerebrovascular disease and chronic kidney disease than those with primary viral pneumonia. "Thus, it is quite possible that comorbid conditions affect the physical functional decline in elderly COVID-19 patients with bacterial coinfection," they wrote.
Because functional decline during or after hospitalization is tied to adverse health outcomes, prolonged hospital stays, and more episodes of early hospital admission, the authors wrote, "it is necessary to consider early rehabilitation and treatment in elderly patients even when the predominant strain is the Omicron variant."
According to the results of a new survey given to Vietnamese patients and published in Frontiers in Public Health yesterday, 76% people who reported mild COVID-19 infections in the previous 6 months said they now experience insomnia, with 22.8% of those respondents saying their insomnia is severe.
The study was based on surveys given to 1,056 adults who had been diagnosed as having COVID-19 in the past 6 months. All study participants were reached through a national Vietnamese register of confirmed COVID cases. No one was hospitalized for their COVID infections, and participants reported no history of insomnia or psychiatric conditions.
Surveys on a range of symptoms following COVID-19 were completed from June to September 2022. In addition to demographic information, participants were asked about the duration and severity of COVID-19 infections, anxiety, depression, or stress symptoms.
Patients were also asked to compare how well they slept, how long they slept, and how easy it was to fall asleep in the previous 2 weeks, compared to before contracting COVID-19.
Among the 76.1% who said they now experienced insomnia, half reported new and frequent episodes of waking up at night since contracting COVID-19. One-third said they experienced difficulty falling asleep.
The 76% figure is much higher than reports of insomnia among the general population, which is between 10% and 20%, the authors note.
The authors found no correlation between initial COVID symptom severity and insomnia. In fact, even people who reported asymptomatic COVID-19 infections reported subsequent insomnia. The researchers also found no correlation between COVID duration and insomnia.
If you experience insomnia after COVID-19, don't think that is normal.
Study participants who saw an increase in depressive or anxiety symptoms following COVID were most at risk for insomnia. Participants with high depression scores (odds ratio [OR], 3.45; 95% confidence interval [CI], 1.87 to 6.34) or anxiety scores (OR, 3.93; 95% CI, 2.52 to 6.13) had more than triple the odds of developing insomnia.
Correlations between insomnia, depression, and anxiety were strong to moderate in the study, the authors said, suggesting a role for pharmacologic treatment of insomnia following COVID-19.
"Our findings add to current literature on insomnia after COVID-19 infection and underscores the crucial need to implement comprehensive interventions to address the psychological and sleep health of COVID-19 patients after recovery," the authors concluded.
In a Frontiers press release on the study, first author Huong T. X. Hoang, MD, of Phenikaa University, Vietnam, said the study confirmed what he had found anecdotally as a sleep researcher: More people reported insomnia after minor COVID-19 infections.
"I received many questions and complaints from relatives, friends, and colleagues about their sleep disturbances after recovering from COVID-19," said Hoang. "If you experience insomnia after COVID-19, don't think that is normal."
Seven of 10 kindergarteners in Cincinnati Public Schoolsthe vast majority racial minority studentswere deemed not ready to learn in the classroom in 2021, confirming the damaging effects of COVID-19 pandemicdisruptions, according to a study published yesterday in JAMA Pediatrics.
Before the pandemic, 60% were not ready for kindergarten, the findings revealed.
A team led by Cincinnati Children's Hospital researchers analyzed the scores of 4,755 kindergarteners who took the state-required Kindergarten Readiness Assessment (KRA) in 2018, 2019, or 2021 (no test was administered in 2020 owing to pandemic restrictions). They did the same with 3,204 matched children with electronic health record data from the hospital's primary care clinics.
The KRA measures skills in early reading and math, gross and fine motor tasks, self-regulation, and attention through 27 teacher-administered questions and tasks.The assessments are scored on a scale of 0 to 300, with 270 considered passing. Average participant age was 5.6 years, 50.3% were boys, 82.5% were Black, 7.6% were White, and 2.9% were Hispanic.
"Early experiences, relationships, and socioeconomic conditions are foundational for early brain development, school readiness, and health outcomes," the study authors wrote. "Racial and socioeconomic opportunity gapsin the skills necessary to learn and succeed in school (including language, preliteracy, math and socioemotional skills such as executive function and self-regulation) start before kindergarten."
They noted that fewer families, especially Black families, used early childhood education (ECE) services and developmental therapies during pandemic disruptions. "Many parents chose not to enroll their children in ECE out of fear of COVID-19 and difficulties navigating the arduous enrollment process," they wrote.
In total, 817 parents (25.5%) reported reading to their child 0 or 1 day a week at least once during the study period, and 865 children (27.0%) didn't pass the age-appropriate, parent-completed Ages & Stages Questionnaire (ASQ) screening questionnaire at least once. Overall, 2,675 children (83.5%) had Medicaid coverage most of the time, 384 (12.0%) experienced food insecurity, and 855 (26.7%) lived with housing insecurity.
Average KRA scores among the primary care patients were significantly lower (260.0; 214 of 998 [21.4%]) in 2021 than in 2019 (262.7; 317 of 1,114 [28.5%]) and 2018 (263.5; 351 of 1,092 [32.1%]), a pattern also seen in the larger school district.
Only 30% of students were deemed kindergarten-ready in 2021, a significant drop from 40% in 2018. Primary care patients displayed a similar pattern, with 21.5% ready for kindergarten in 2021, compared with 32% in 2018.
A final linear regression model involving 2,883 participants identified risk factors for a failing KRA score as a low ASQ score after 18 months of age (6.7 points below average score of 270.8); Medicaid coverage (5.7 points), Hispanic ethnicity (3.8), need for an interpreter (3.6), 2021 testing year (3.5), male sex (2.7), rare parental reading to child (1.5), and food insecurity (1.2). Race, caregiver depression, housing insecurity, and difficulty receiving benefits weren't linked to KRA scores.
"This means that 7 of every 10 children in the Cincinnati Public Schools were considered not ready to learn when they entered kindergarten during the pandemic," lead author Kristen Copeland, MD, said in a hospital news release. "It will take intense effort on multiple levels to help these children overcome this disruption."
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A federal appeals court in New Jersey ruled Monday that residents refusal to wear face masks at a school board meeting during the COVID-19 pandemic is not protected as a free speech right.
The 3rd Circuit Court of Appeals issued a ruling in two similar cases that stemmed from lawsuits against officials in Freehold and Cranford, N.J. The plaintiffs refused to wear masks during public meetings and say they were retaliated against by the school board, The Associated Press reported.
In the wake of the COVID-19 pandemic, federal, state, and local governments scrambled to implement policies to control the spread of the disease. These measureswhich included mandates to wear face masks in public indoor spaces such as schools, businesses, and restaurantsspawned skepticism and debate, the court wrote in its ruling Monday. Some objectors voices their discontent online, some turned to their elected representatives, and some asked the courts to intervene.
The court sent one case, by George Falcone, back to a lower court and said in the other lawsuit, by Gwyneth Murray-Nolan, that the plaintiff failed to show she was retaliated against.
While the cases were dismissed for different reasons, the court ruled that like all courts to address this issue, refusing to wear a protective mask required by health and safety orders during a public health emergency is not protected as a First Amendment right.
Skeptics are free toand didvoice their opposition through multiple means, but disobeying a masking requirement is not one of them, the ruling said. One could not, for example, refuse to pay taxes to express the belief that taxes are theft. Nor could one refuse to wear a motorcycle helmet as a symbolic protest against a state law requiring them.
New Jerseys statewide order for public mask wearing in schools ended in March 2022, shortly after the incidents in the lawsuits, the AP noted.
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A recentNature Machine Intelligencestudy investigated the efficacy of audio-based artificial intelligence (AI) classifiers in predicting severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection status. SARS-CoV-2 is the causal organism of the coronavirus disease 2019 (COVID-19) pandemic.
Study: Audio-based AI classifiers show no evidence of improved COVID-19 screening over simple symptoms checkers. Image Credit:Aliaksandra Post/ Shutterstock
Since SARS-CoV-2 infection could cause both symptomatic and asymptomatic manifestations, it is important to develop accurate tests to avoid general population quarantine. Previous studies have revealed that AI-based classifiers trained with respiratory audio data could identify SARS-CoV-2 status.
Although these studies indicated the effectiveness of AI-based classifiers, many challenges surfaced while applying them in real-world settings. Some factors that withheld AI-based classifier applications were sampling biases, unvalidated data on participants' COVID-19 status, and delay between infection and audio recording. It is imperative to determine whether the audio biomarkers of COVID-19 are unique to SARS-CoV-2 infection or are inappropriate confounding signals.
The current study focussed on determining whether audio-based classifiers can be accurately used for COVID-19 screening. A large-scale polymerase chain reaction (PCR) dataset linked to audio-based COVID-19 screening (ABCS) was used. For this study, participants of the Real-time Assessment of Community Transmission (REACT) program and the National Health Service (NHS) Test-and-Trace (T+T) service were invited. All relevant demographic data was extracted from T+T/REACT records.
Participants were asked to complete survey questions and record four audio clips. For audio recordings, they were asked to read a specific sentence, followed by three successive exhalations, making a "ha" sound. Furthermore, the participants were asked to record forced coughs once and three times in succession. All recordings were documented in .wav format. The quality of the audio recordings was assessed, and 5,157 records were removed for quality-related issues.
Human figures represent study participants and their corresponding COVID-19 infection status, with the different colours portraying different demographic or symptomatic features. When participants are randomly split into training and test sets, the randomized split models perform well at COVID-19 detection, achieving AUCs in excess of 0.8; however, matched test set performance is seen to drop to estimated AUC between 0.60 and 0.65, with an AUC of 0.5 representing random classification. Inflated classification performance is also seen in engineered out of distribution test sets such as: the designed test set, in which a select set of demographic groups appear solely in the testing set, and the longitudinal test set, in which there is no overlap in the time of submission between train and test instances. The 95% confidence intervals calculated via the normal approximation method are shown, along with the correspondingnnumbers of the train and test sets.
In this study, a respiratory acoustic dataset of 67,842 individuals was collected. Among them, 23,514 individuals tested positive for COVID-19. All data were linked with PCR test results. It must be noted that the most significant number of COVID-19-negative participants were recruited from six REACT rounds compared to the T+T channel.
The dataset considered in this study exhibited promising coverage across England. No significant association between geographical location and COVID-19 status was noted. The highest level of COVID-19 imbalance was found in Cornwall. A previous study indicated recruitment bias in ABCS, particularly linked with age, language, and gender, in both training data and test sets. Despite this bias, the training dataset was balanced in accordance with age and gender across COVID-positive and COVID-negative subgroups.
Consistent with previous studies, the unadjusted analysis conducted in this study exhibited that AI classifiers can predict COVID-19 status with high accuracy. However, when measured confounders were matched, a weak performance of AI classifiers in detecting SARS-CoV-2 status was observed.
Based on the findings, the current study proposed some guidelines to rectify recruitment bias's effect for future studies. Some of the recommendations are listed below:
The current study has come with limitations that include the possibility of potential unmeasured confounders across REACT and T+T recruitment channels. For instance, PCR testing for COVID-19 was performed several days after self-screening of symptoms. In contrast, PCR tests in REACT were conducted on a pre-determined date, irrespective of the onset of symptoms. Although the majority of confounders were matched, there is a possibility of the presence of residual predictive variation.
Despite the limitations, this study highlighted the need to develop accurate machine-learning evaluation procedures to obtain unbiased outputs. Furthermore, it revealed that confounding factors are hard to detect and control across many AI applications.
Journal reference:
From February 2-7, 2024, the City of Port Arthur Health Department is reporting 35 COVID-19-positive cases for Port Arthur, Groves, Nederland, and Port Neches.
Please contact the PAHD for questions at 409-983-8800 (main line), or (409) 983-8832. Staff are happy to help in any way!
An 8-week online rehabilitation program helped long-COVID patients improve their quality of life, according to a new study published in The BMJ.
Compared to standard care, UK patients who completed online group sessions as part of the REGAIN program saw less fatigue, pain, and depression, in one of the first trials to measure outcomes of a long-COVID rehab program. The trial took place between January 2021 and July 2022.
The trial participants included 585 adults (average age 56 years) who had been hospitalized for COVID-19 at least 3 months earlier and reported substantial lasting symptoms. Overall, 88% of participants were overweight or obese, and 34% had been admitted to the intensive care unit (ICU) for COVID.
Baseline health-related quality of life was low, and 43% of participants had a mental health disorder, the authors said.
"The most common pre-existing medical conditions related to chest or breathing (444/585; 76%) and musculoskeletal conditions (275/585; 47%), and more than one third of participants were unable to work owing to post-covid-19 condition (222/585; 38%)," the authors wrote.
Half of the participants (287) were randomized to receive standard care (a single online session of advice) and 298 to the REGAIN intervention (eightweekly home-based, group exercise and psychological support sessions delivered online).
Participant outcomes were assessed at 3, 6, and 12 months.
At 3 months, 17% (39) of the intervention group reported that their overall health was "much better now" compared with 8% (20) in the usual-care group. One serious adverse event of fainting and vomiting after exercise was deemed possibly related to the intervention, and two adverse events (knee pain with exercise, and severe anxiety before exercise) were deemed definitely related, the authors said.
There were no improvements at the 6-month mark, but by 12 months participants in the REGAIN group showed significant improvements.
Overall participants in the REGAIN intervention group had higher odds (odds ratio 1.66; 95% confidence interval, 1.14 to 2.41) of being more physically active compared with participants in the usual care group.
Importantly, the magnitude of improvement in the REGAIN intervention group for post-traumatic stress disorder was twofold greater than in the control group.
"This is an important finding given the high levels of post-traumatic stress disorder witnessed in this population, and the known impact of this on health related quality of life and social and economic productivity," the authors said.
In an editorial on the study, professors of exercise science from two universities in Australia emphasized there were no cases of myalgic encephalomyelitis/chronic fatigue syndrome reported in the REGAIN group.
Regular monitoring in the REGAIN trial did not identify any episodes of post-exertional exacerbations of symptoms.
"Regular monitoring in the REGAIN trial did not identify any episodes of post-exertional exacerbations of symptoms, providing reassurance that individualised exercise at home in online groups supervised by a trained physiotherapist or exercise physiologist is safe," the authors wrote.
