"In order to improve the care and quality of life for those who experience long-term neurological symptoms after COVID-19, we need to understand the underlying causes of post-COVID condition," senior author Magnus Gisslen, MD, PhD, of the University of Gothenburg, said in the release. "This study provides new insights into the condition, and can thus represent a valuable contribution to ongoing discussions and research."
In the second study, published yesterday in BMC Infectious Diseases, University of Bergen researchers in Norway parsed national registry data to assess the prevalence of and risk factors for long COVID at least 3 months after infection.
A total of 53,846 people who tested positive for COVID-19 from February 2020 to February 2021 were compared with 485,757 uninfected matched control participants. The average age was 41 years, 51.6% were men, and most were unvaccinated.
COVID-19 survivors had higher rates of most studied symptoms than controls, with the greatest risks for shortness of breath (hazard ratio [HR], 2.75), fatigue (HR, 2.08), memory loss (HR, 1.41), and headache (HR, 1.39).
Risk factors included outcome symptoms that began before the COVID-19 pandemic, but the associations were weaker among COVID-19 survivors. Underlying medical conditions weren't tied to fatigue or shortness of breath among the infected, but both the infected and uninfected groups had a slightly higher risk of memory loss, with higher comorbidity scores. Women were more at risk for fatigue and shortness of breath than men in both groups.
Hospitalization for COVID-19 moderately increased the risk for fatigue (relative risk [RR], 1.61) and memory loss (RR, 1.58) but was a marked risk factor for shortness of breath (RR, 2.32) after infection, compared with the nonhospitalized COVID-19 group.
"We found that the risk of fatigue or shortness of breath were more than doubled 3 to 12 months after COVID-19 compared to a control group of unexposed persons," the researchers wrote. "The likelihood for memory disturbance, other respiratory symptoms, pain in abdomen, chest and musculoskeletal system and headache were also significantly higher in the COVID-19 group."
A study of three hospitals in Chicago found that increased use of antibiotics at the outset of the COVID-19 pandemic was limited to COVID-19 patients, researchers reported yesterday in Infection Control & Epidemiology.
To determine differences in antibiotic use between COVID-19 and nonCOVID-19 patients, a team led by researchers from Rush University Medical Center analyzed electronic health record data from three tertiary acute-care hospitals covering the preCOVID-19 period (March to December 2019) and the COVID-19 period (March to December 2020). They stratified patients by COVID-19 status, calculated relative percentage differences in antibiotic use in COVID-19 versus nonCOVID-19 patients during the two periods, and also compared antibiotic use in nonCOVID-19 patients during the two periods.
Facility-wide antibiotic use for all antibiotics was significantly greater in COVID-19 patients compared with nonCOVID-19 patients in two of three hospitals during the COVID-19 period, and use of broad-spectrum agents for hospital-onset infections was significantly greater in COVID-19 patients versus nonCOVID-19 patients in all three hospitals during both the COVID-19 period (with relative increases of 73%, 66%, and 91% for hospitals A, B, and C, respectively) and the preCOVID-19 period (with relative increases of 52%, 64%, and 66% for hospitals A, B, and C, respectively).
In contrast, facility-wide antibiotic use for all antibacterial agents was significantly lower in nonCOVID-19 patients during the COVID-19 period versus the preCOVID-19 period (with relative decreases of 8%, 7%, and 8% in hospitals A, B, and C, respectively).
The study authors say the increased use of broad-spectrum antibiotics at the beginning of the pandemic "likely resulted from the diagnostic and therapeutic uncertainty in the context of high mortality rates," while reduced antibiotic use in nonCOVID-19 patients during that period could reflect both the durability of antimicrobial stewardship efforts and changes in inpatient populations.
"Elective procedures were deferred, admissions for less critical illnesses were reduced, and the most chronically ill patients who ordinarily would have been admitted for nonCOVID-19 indications may instead have been admitted with COVID-19," they wrote.
Latin-American parents and caregivers in L.A. County say they need trusted sources of information before vaccinating their children against COVID-19, according to a new study led by a Cedars-Sinai investigator.
The findings are published in the peer-reviewed journal Vaccines.
The big message for primary care providers is that our words hold so much weight when it comes to helping patients make informed decisions, said lead author Yelba Castellon-Lopez, MD, a primary care provider and a research scientist in the Department of Biomedical Sciences at Cedars-Sinai. Taking a moment to ask why can help you learn so much.
In October 2021, the U.S. Food and Drug Administration authorized two COVID-19 vaccines for emergency use in children ages 5-11, but many eligible children remain unvaccinated.
In L.A. County, less than half of children ages 5-11 are vaccinated against COVID-19. These rates are even lower for Latin-American children in the area: Only 27.7% of these children had received at least one dose of a COVID-19 vaccine as of August 2023.
In March and April 2022, investigators conducted six virtual focus groups with 47 parents and caregivers of children ages 5-11. The parents and caregivers were recruited because of their participation in another study that assessed the effectiveness of MiVacunaLA, a mobile-phone text-based program meant to educate parents and caregivers and improve vaccination rates. Half of the parents and caregivers had been exposed to the intervention and half had not.
Answers from parents and caregivers fit into the following general themes:
Parents also said doctors and scientific studies are trusted sources of COVID-19 vaccine information and that they appreciate text messages containing information about COVID-19 vaccines. The investigators found that digital content, such as videos featuring doctors, can help parents in their decision-making.
The investigators are continuing to study how the MiVacunaLA program improves parents likelihood of vaccinating their children.
Funding: The study was funded by the VaxUp Innovation Challenge Grant sponsored by Childrens Hospital Los Angeles, the Los Angeles Department of Public Health and CEAL/STOP COVID-19 CA.
Read more on the Cedars-Sinai Blog:Tips to Navigate a COVID-19 Infection in Your Household
IRVINE A UC Irvine study published Thursday in a science journal showed that last year 38 business in North America marketed unproven stem cell therapies and exosome products to treat or prevent COVID-19.
The businesses operated or had ties to 60 clinics 24 in the United States and 22 in Mexico, with the rest in Guatemala, Malaysia, Poland and Spain, according to the study published in Stem Cell Reports.
The businesses touted treatments long-COVID and immune boosters to prevent or treat infection.
The scientists involved in the study said such untested treatments can pose health hazards such as minor complications to more serious afflictions like pumonary embolisms, cardiovascular issues and acute bacterial infections. The treatments dont come cheap either with costs ranging from $2,950 to $25,000, which are not covered by insurers.
Patients suffering from long COVID are the primary marketing target of businesses engaged in direct-to-consumer advertising of stem cells and exosome products for COVID-19, the scientists wrote in the study. It is understandable that individuals seeking relief from shortness of breath, fatigue, brain fog, heart palpitations, loss of smell and other symptoms search for interventions that might help them.
Those afflicted with lingering symptoms of COVID-19 are vulnerable to having their suffering, desperation and hope exploited by entities making appealing therapeutic claims without having the scientific evidence needed to make such representations, the studys authors wrote. Likewise, there is no current scientific consensus that stem cell interventions and exosome products can reliably prevent individuals from being infected by SARS-CoV-2 or boost their immune systems in such a manner that their risk of infection is reduced. Such marketing claims are distinct from translational research efforts that have responded to the pandemic by generating meaningful safety and efficacy data for specific stem cell interventions and exosome products.
Leigh Turner, professor of health, society and behavior in UCIs Program in Public Health and an author of the study said the exploitation of those suffering from long COVID is very alarming, because these people are not accessing evidence-based treatments that have been reviewed and approved by national regulators. When going online looking for stem cell or exosome treatments, people need to be alert to the possibility of scams.
The studys authors were struck by the fact that two dozen of the clinics were U.S.-based because federal agencies have been issuing warning letters to companies that mislead consumers about unproven stem cell and exosome products.
But some of the businesses stop the marketing when they get a warning letter while others dodge regulators with new clinics opening.
Turner recommended further regulatory oversight, research, testing and approval of stem cell treatments and exosome therapies for COVID-19.
Alston & Bird is now one of the latestemployers to be sued for allegedly firing an employee for not complying with COVID-19 vaccine mandates.
Alston, an Am Law 100 firm with about 1,600 employees worldwide, on Wednesday asked that a September lawsuitfiled by former legal assistant Joanne Halvorson in Gwinnett County Superior Court be moved to the Atlanta Division of the U.S. District Court for the Northern District of Georgia.
Community Health Alliance (CHA) will be hosting flu and COVID-19 vaccine clinics at various Washoe County School District (WCSD) schools in October and November.
Vaccines will be available for students 5-years-old and above.
A parent or legal guardian must be present for students to receive a vaccine, and guardians are asked to bring an identification card and health insurance card if applicable.
Most health insurance plans cover the cost of vaccines.
For those who are uninsured, CHA's community health partners Adobe Population Health, Anthem, Immunize Nevada, and Molina Healthcare of Nevada are offering free vaccines while supplies last.
Below is the vaccine clinic schedule:
For children under the age of four, or people who can not attend the clinics, guardians can call 775-329-6300 to make an appointment at Community Health Alliance.
Appointments can also be made online at chanevada.org
(CHA assisted with this report.)
Ken Shamrocks bare-knuckle boxing promotion is back on track.
The MMA pioneers Valor Bare Knuckle returns Friday with VBK 2, which takes place at the University of North Florida in Jacksonville, Fla. The event is Valors first show since its 2019 debut, a hiatus triggered by the 2020 COVID-19 shutdown.
Despite seeing the promotions momentum sputter amid the pandemic, Shamrock told MMA Fighting he and his team never considered shutting it down for good.
Never, ever, ever thought we werent coming back, Shamrock said. Never. We were always working behind the scenes, building structure within our business while creating apps through which we could stream our fights. Theres a lot of stuff that weve been doing. Obviously, in my mind, experiencing the fan base, even experiencing early on when I was just fighting in the back of bars, not a lot of people there, its just not the same if you dont have a fan base and your business is out there giving fans something they want to see.
We waited for a time to come back, he continued. Obviously, this is fight where theres a lot of fans going to Florida that weekend with the Florida-Georgia game. I think its a great opportunity for people that are there to have a great weekend, come out and watch the fights on weekend, go watch Florida-Georgia college football on Saturday, and then to close it all off, Sunday NFL football. So its a great weekend. I know thats what Im doing. But yeah, when they come out and look at the ring sets, the belts, Oct. 27 at the UNF Arena in Jacksonville, were going to have some great fights, and theres going to be some fun that night.
Considering how the aftermath of VBK 1 went, Shamrock was due for a bit of luck. He hopes that the second event benefits from a major sports weekend in Jacksonville. His team initially considered moving away from the crowded slate when the schedule materialized, but they later decided it was a blessing and not a curse.
Plans ended up changing anyway with one fighter bowing out of Fridays main event. Lavar Johnson was originally scheduled to fight Mark Godbeer, but MMA lifer Travis Wiuff stepped in for Godbeer to face his fellow cagefighting veteran.
This is a big opportunity for Johnson, who lived up to his reputation as a knockout artist at VBK1 with a 27-second drubbing of James McSweeney. He is now poised to be one of the names the promotion can build around.
First of all, hes just a great individual, Shamrock said of Johnson. A guy whos overcome adversity. He went through some hard times early on, just like myself, I went through some really tough times. To be able to see somebody be able to change their life and be able to get back on the right track again is also always golden. You love to see that, but I think as a fighter I just love how he actually carries himself. Hes respectful, but hes dangerous, and he has absolutely no thoughts about going in there and just knocking the p*** out of you. But outside the ring, hes an absolute gentleman, so I really like that about him.
But again, I tell people, do not look past this because this guys a beast. He may be a little bit older, but this guys got power, and he touches you, youre doing down.
Johnsons punching power has always been respected, with 17 of his 18 MMA wins coming by way of knockout, including memorable first-round finishes of Pat Barry and Joey Beltran. He showed little in the way of an all-around game, which put a clear ceiling on his fighting career. But he looked like a natural fit for the world of bare-knuckle boxing when he debuted against McSweeney.
Shamrock agreed with the suggestion that Johnson, who previously competed for Bellator and UFC, might have become a bigger star if hed had the option of doing bare-knuckle.
Absolutely, Shamrock said. I think theres a lot of guys you see, just regular boxers, that havent really been able to do well, theyre average in there, but they have this knockout power. Theres guys like myself, guys that have that beast mode and power and you literally just destroyed someone, but because they landed more punches, they get the win. That power literally changes everything for the larger guys that are the true beasts.
A veteran of 101 documented MMA fights, Wiuff is perfectly poised to play the spoiler against Johnson. Diesel has seen it all in his combat sports career, having fought his way across the U.S. for the past 22 years. Shamrock warns Wiuff is definitely not to be underestimated.
Hes smart, Shamrock said. He knows when to turn it on, when not to turn it on. He knows when to move, and hes a smart fighter. He has a lot of tools to bring out against Lavar and hes going to have to, because I think Lavar is just going to be going for that knockout. If he doesnt, Travis is capable of doing it.
Just being able to move and set up his punches, it could be a problem for Lavar because Lavar isnt that experienced when it comes to that movement. Hes more of that straightforward, big punches. So if Travis comes out and fights smart, this is going to be a very, very good fight.
Tickets are available now for VBK 2 and a live stream airs Friday on the Valor BK official website (free subscription required) beginning at at 7 p.m. ET.
Read more
Adult long-COVID patients in England reported worse mental health and related quality of life than those who were never infected or recovered from their infections, suggests a study yesterday in Nature Communications.
Imperial College London researchers analyzed self-reported mental health and quality of life among 276,840 participants from August to December 2022.
The team also used data from a follow-up survey of participants in the REal-time Assessment of Community Transmission-2 study, which included six rounds of random samples of the population to evaluate community prevalence of SARS-CoV-2 antibodies in England.
Overall, 59.1% of participants had tested positive for COVID-19.Symptoms among 130,251 respondents lasted for, on average, 5.4 weeks (range, 1 day to 3 years). In total, 7.5% and 5.2% reported symptoms for at least 12 weeks (long COVID) and 52 weeks or longer (very long COVID), respectively.
Risk factors for long or very long COVID included female sex (adjusted odds ratio [aOR], 1.42 and 1.49, respectively), having at least one underlying condition (aOR, 1.31 and 1.52), and moderate or severe COVID-19 (aOR, 1.76 and 1.47).
Although COVID-19 is usually of short duration, some adults experience persistent and burdensome illness, although a sizeable proportion still recover after a prolonged period.
The probability of long COVID and very long COVID was lower in Asian than in White people (aOR, 0.80 and 0.71, respectively) and in those infected during the Alpha (aOR, 0.60 and 0.59), Delta (OR, 0.38 and 0.32), or Omicron waves (OR, 0.12 for long COVID; insufficient follow-up time for very long COVID) than in those with wild-type infections.
The most common ongoing symptoms were mild fatigue (66.9%), difficulty thinking or concentrating (54.9%), and joint pain (54.6%). The greatest difference in symptom prevalence between those with ongoing symptoms and other participants were for altered smell (aOR, 9.31) or taste (aOR, 8.47), shortness of breath (aOR, 6.69), severe fatigue (aOR, 6.19), difficulty thinking or concentrating (aOR, 4.97), chest tightness or pain (aOR, 4.71), and memory loss (aOR, 4.40).
"Although COVID-19 is usually of short duration, some adults experience persistent and burdensome illness, although a sizeable proportion still recover after a prolonged period," the authors wrote.
The abortion drug Mifepristone, also known as RU486, is pictured in an abortion clinic February 17, 2006 in Auckland, New Zealand. (Photo by Phil Walter/Getty Images)
A version of this article originally appeared in the Daily Hampshire Gazette.
In nations banning abortion across the world, activists have created community support networks facilitating access to abortion pills. In June 2022, when the Supreme Court eliminated constitutional abortion rights in Dobbs v. Jackson Womens Health Organization and many states banned abortion, U.S. activists were ready to create their own alternative supply systems for abortion pills.
Over the last several years, in anticipation of the Supreme Court overturning Roe v. Wade and in response to the Covid pandemic, activists developed interstate telemedicine abortion services and community support networks that are now providing abortion pills to people living in all 50 states, including states with bans. As a result, abortion pills are now more accessible and affordable than ever before.
Two medications are used for early abortion: mifepristone, which blocks the effects of the pregnancy-sustaining hormone progesterone; and misoprostol, a commonly-used ulcer medication that causes contractions to expel pregnancy tissue. Used in combination, these medications are 98 percent effective in the first 12 weeks of pregnancy and safer than Tylenol.
Before COVID-19, abortion pills were hard to access and expensive. Despite being safe and easy to use, the abortion pill mifepristone was more heavily restricted than opioids. The FDA allowed only certified physicians to dispense abortion pills, which they were required to do in personan unusual and medically unnecessary requirement. These restrictions combined with an expensive medical system meant that patients had to pay an average of $560 for an abortion with pills at U.S. clinics, despite the fact that the pills are used at home and cost only two to three dollars per dose to manufacture.
During COVID-19, reproductive health advocates challenged these FDA restrictions in court, leading to a shift in FDA policy to allow telemedicine abortion for the first time. As a result, clinicians could prescribe the medication remotely and mail abortion pills to patients for a much lower cost. Telemedicine abortion clinics quickly sprouted up in about half of states.
After Dobbs, several states passedtelemedicine abortion provider shield laws that allowed clinicians licensed in those states to provide telemedicine abortion to people living in any state. With these new protections, telemedicine abortion providers began serving patients in states with abortion bans.
One interstate telemedicine abortion clinic, Aid Access, recently reported they are mailing abortion pills to 5,500 people living in states with abortion bans each month. Whereas before COVID-19, patients had to travel hundreds of miles to brick-and-mortar clinics, walk a gauntlet of protesters and pay on average $560 for medication abortion, now they can obtain these pills from the privacy of their own homes for a sliding scale fee of up to $150 in all 50 states.
Access to these safe and easy-to-use medications has increased outside of the medical system as well. In response to new abortion bans,community support networkssuch as Red State Access, Las Libres, AccessMA, and WeSaveUs began sending free abortion pills to people living in states banning abortion. Meanwhile, increased demand led to a proliferation of websites selling pills, which dropped their prices from hundreds of dollars before Dobbs to as low as $37 per dose today.
The creative actions of reproductive health advocates in response to COVID-19 and Dobbs have ripped away decades of political and medical red tape and finally placed abortion pills directly in the hands of people who need them.
Information about these community support networks and vetted websites selling pills is readily available from the organization Plan C, which conducts research and publicly shares information about how people are accessing abortion pills in the United States. Confidential support services have developed, including the Miscarriage +Abortion Hotline with medical professionals ready to assist people using abortion pills, the Reprocare Healthline providing logistical and emotional support, and the Repro Legal Hotline available to answer legal questionsall at no charge. People can also find support at the abortion subreddit run by OARS, the Abortion Online Resource Squad. A new online chatbot namedCharleyhelps abortion seekers in all 50 states find quick, accurate and confidential abortion information, tailored to their individual needs and circumstances.
These seismic changes in abortion pill access have broken through decades of political and medical barriers that have limited access to abortion pills. The climate of fear and intimidation created by the anti-abortion movement led to overregulation of this safe and easy-to-use medication and few clinicians willing to navigate these burdensome restrictions, which blocked increased access and drove up prices. New pathways for accessing abortion pills spurred by COVID-19 and Dobbs have finally freed mifepristone from the vise grip ofthese unjust political and medical barriers.
Anti-abortion extremists are now trying once again to limit access to abortion pills in a lawsuit currently on appeal at the Supreme Court, but the cat is out of the bag. Even if they win this lawsuit, the robust alternative supply networks established in the wake of Dobbs will persist. The creative actions of reproductive health advocates in response to COVID-19 and Dobbs have ripped away decades of political and medical red tape and finally placed abortion pills directly in the hands of people who need them.
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