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We Found A COVID-19 Vaccine In Months. What About One For HIV?

20/1/2021

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When Pfizer and BioNTech announced their astounding SARS-CoV-2 vaccine efficacy results in November, Arthur Reed was ecstatic.

“The global investment and coordination of billions of dollars enabling this unprecedented pace of scientific discovery is truly an incredible achievement,” he said.

But as a gay man in New York City living with HIV since the 1980s, he couldn’t help but wonder about the government and public response to SARS-CoV-2, the virus that causes COVID-19, compared to the early days of HIV/AIDS.

“Unfortunately, in both cases there has been immense stigma against minority communities,” Reed said. “Calling COVID-19 the ‘Chinese Virus,’ and the ensuing rise in anti-Asian scapegoating, feels eerily similar to when people labeled HIV as ‘gay-related immune deficiency’ and shunned us from society.”


What Reed finds especially triggering are the COVID-19 hospital policies that don’t allow visitors, and the patients having to die alone in isolated hospital beds. Media images of FaceTime farewells and sparsely populated funerals painfully remind him of an earlier decade, when patients with HIV/AIDS — many of whom were his closest friends — also died alone. This happened not only because of hospital policies, but because of discriminatory social dynamics and a vicious lack of acknowledgement of the deadly disease at the uppermost rungs of the federal government.

“I lost over 100 friends in the early days of HIV. And it was awful, because these people were like my family,” he said. “The worst part of it all was that it also took my partner’s life.”

The deep and reverberant trauma from these losses and his own fight against the virus have motivated him to keep up with the latest research on HIV. And while he has nothing but awe and praise for the scientists working on these viruses, he cannot help but wonder how a vaccine against SARS-CoV-2 was developed in less than a year — especially since developing new vaccines is a process that typically takes eight to 10 years — while there’s been nothing on the horizon for HIV in nearly four decades.

Reed’s not the only one wondering about this. On World AIDS Day, observed annually on Dec. 1 ― which this year fell only a few weeks after Pfizer’s announcement ― commenters on Twitter amplified the differences between SARS-CoV-2 and HIV vaccine development. Many offered conspiratorial “explanations” for the lack of an HIV vaccine.

Some theorized that the sole reason for this discrepancy is that HIV mostly affects trans people of color and men who have sex with men — marginalized groups without much political clout. Since SARS-CoV-2 is affecting all levels of society (even though the ultimate health outcomes are worse for ethnic minorities), they believe it has garnered quicker attention and unprecedented monetary investment, leading to a (thus far) successful vaccine.

Other commenters have falsely claimed that HIV is “money-making” for governments and pharmaceutical companies alike, and so vaccines have been strategically withheld.

It’s always hard to argue against more funding, since every step of the scientific discovery process is extremely resource-intensive. But it is worth noting that since 1982, federal funding for HIV has increased exponentially, to nearly $35 billion in 2019 alone. Additionally, private funders like the Bill & Melinda Gates Foundation have provided critical financial support over the decades.

To put this in the financial context of Operation Warp Speed ― a public-private partnership initiated by the United States government to facilitate SARS-CoV-2 vaccine discovery, therapeutics and diagnostics ― nearly $18 billion has been budgeted for the project.

“At the moment, I don’t think funding is necessarily the biggest bottleneck to an HIV vaccine breakthrough, although more funding never hurts,” said John Moore, a professor of microbiology and immunology at Weill Cornell Medicine in New York City who has been studying HIV vaccine development for over 20 years.

“At the end of the day, it’s the fundamental differences in the biology of HIV and SARS-CoV-2 that make developing a vaccine so difficult — not for a lack of trying,” Moore said. He dismissed the conspiracy theories as “absurd.”

“Some of these conspiracy theories have unfortunately been around for a while,” said Gregg Gonsalves, an assistant professor of epidemiology at the Yale School of Public Health and a renowned HIV activist. “Now more than ever, we have to continue meeting people where they’re at and identify trusted messengers within communities to dispel these myths.”

Why making a COVID-19 vaccine was faster

While it feels intuitive to compare the two viruses, there are only a few molecular-level similarities. The most prominent is that they both have “spike” proteins ― knob-like structures jutting out of their surfaces (though the structures on the two viruses differ in composition).

Both viruses use these spike proteins to bind to receptors, which are molecules that sit on the surfaces of human cells. In the case of SARS-CoV-2, the virus binds to cells with the ACE2 receptor found in the lungs, small intestine, blood vessels and many other parts of the body — which is why it is not surprising that COVID-19 affects so many different organs. HIV, however, binds to different receptors of immune system cells.

After entry into the cell, the two viruses do very different things. SARS-CoV-2 makes numerous copies of itself, which allows it to go on to infect more cells in the body.

HIV, on the other hand, has a much more sophisticated replication process. One of the most notable differences is that HIV particles have a way to replicate the virus’ genetic material so it becomes integrated into the human cell’s DNA. SARS-CoV-2 cannot emulate this mechanism.

So what does all of this mean for vaccines? What makes it so difficult to produce one for HIV?

“Among a whole host of factors, HIV has an extremely high mutation rate that impacts the architecture of the spike protein antibody recognition sites. And these mutations can happen daily, which is a significant challenge to HIV vaccine development,” Moore said. “On the other hand, the SARS-CoV-2 spike protein has been fairly static up until recently.” This gave scientists a chance to develop an effective vaccine, since that spike protein wasn’t changing too much.

SARS-CoV-2 mutants are now gaining traction. But there is little evidence so far to suggest that the currently available vaccines will be ineffective against these mutant strains. However, Moore said, “we cannot completely rule out the possibility of having to tweak the vaccines in the future to account for these mutations.”

Another critical difference between the two viruses is the topography of the receptor binding domains — areas on the spike proteins that, if strategically hindered by antibodies, can prevent the virus from attaching to its host cell altogether.

“In SARS-CoV-2, this region sticks out like a sore thumb, which makes it relatively targetable by antibodies,” Moore said. “But in HIV, the site is not only buried but also heavily coated with sugars.” This makes it difficult to prevent a fusion to a cell.

But decades of tedious HIV vaccine research have not been entirely futile.

“It is important that people — especially those spewing conspiracy theories —realize that a lot of the things we learned from years of grueling HIV research have paved the way to formulate vaccines and therapeutics against SARS-CoV-2,” said Kenneth Mayer, the medical research director and co-chair of the Fenway Institute in Boston and a professor in the department of global health and population at Harvard T.H. Chan School of Public Health.

As one example, the Moderna and Pfizer/BioNTech vaccines both deliver the SARS-CoV-2 spike protein through messenger RNA (or mRNA) technology. Immune cells sense the spike proteins and produce a huge reservoir of antibodies in response. If a vaccinated person comes in contact with the virus, they start making antibodies. Along with already-primed white blood cells, these antibodies kick in, neutralize the virus and prevent it from infecting a cell.
This approach originally emerged from better understanding the surface proteins of HIV and engineering antigens to elicit an immune response. But so far, this approach has been unsuccessful for HIV because of its high genetic diversity and rates of mutation.

As another example, the University of Oxford/AstraZeneca vaccine uses a weakened common-cold adenovirus to introduce the SARS-CoV-2 spike protein to generate antibodies. (Note: This isn’t the coronavirus that causes COVID-19, and it won’t make the recipient sick with the disease.)

“Again, this approach stems from HIV vaccine trials from the early 2000s, where weakened adenoviruses were used to deliver genes found in HIV,” Mayer said. While those initial trials yielded disappointing results, fine-tuning the underlying principle has led to successes with numerous other viruses, including SARS-CoV-2.

It is worth noting that the HIV research community hasn’t completely walked away from using these adenoviruses to advance trials. In fact, the same adenovirus currently being studied in a large Janssen HIV vaccine trial is also being used in their COVID-19 vaccine trial.

What’s next for HIV vaccine research

While the long-term effectiveness of vaccines against SARS-CoV-2 will continue to be monitored — especially in light of the new mutant strains — there are several ongoing and future directions for HIV vaccine development.

“Currently, one of the more promising avenues is the use of broadly neutralizing antibodies,” or bNabs, said Douglas Nixon, a professor of immunology in medicine at Weill Cornell Medicine.

These are specialized proteins that can bind to and neutralize a wide range of HIV subtypes, as opposed to non-broadly neutralizing antibodies, which can only nullify one strain of the virus. From studying individuals who seem to have an innate resistance to HIV infection, researchers can continue to identify how these bNabs are generated and, hopefully, test them out in clinical trials.

Another approach that scientists are working on is known as “kick-kill.” While there is still a lot more to learn, the idea here is to use one set of compounds that can “kick” HIV from its dormant state in cells, and another set to kill the freely circulating viruses.

Also, a question that’s on everyone’s mind is whether an mRNA vaccine, similar to what’s being used for SARS-CoV-2, will work for HIV. While there are no human trials yet, Moderna does have an ongoing investigation in monkeys, and the results have inspired cautious optimism. If the data continues to look promising, then human trials could well be on the horizon.

“But beyond the science alone, there are some critical ethical considerations when it comes to designing HIV vaccine trials,” Mayer said. “Since we still don’t know of any [preventative] medication for SARS-CoV-2, it’s easier to have a placebo arm. But that’s not the case for HIV, because we have medications like Truvada and Descovy that can be taken as pre-exposure prophylaxis that effectively stop the transmission of HIV.”

As a result, when recruiting people for HIV vaccine trials, the inclusion criteria get very tricky, which adds more time to the design and implementation of studies.

The other big barrier involves attracting talent to the U.S., given the “myopic immigration policies” of the past four years, Moore said. “Many of us investigators are having to deal with these consequences in our own labs, and having to figure out ways to recruit and retain these highly talented people.”

But with hopes of more inclusive immigration policies under the Biden administration ― and continued financial and scientific investments in HIV research ― great strides can be made in advancing this field.

“A huge collaborative momentum has already begun with Operation Warp Speed,” Nixon said. “Let’s keep it going with ‘Operation Warp Speed for HIV Too,’ or Operation HIVVAX, or Operation Hyperdrive, whatever you want to call it.”

Source: Huffpost

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November 27th, 2020

27/11/2020

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The UK's National Health Service (NHS) is to pilot a simple blood test that may detect more than 50 types of cancer and, it is hoped, could help thousands of people by allowing the disease to be treated more successfully at an earlier stage.

The Galleri blood test, developed by Californian healthcare company Grail, will be piloted with 165,000 patients in what the NHS described as a "world-first deal" in a news release Friday.
Grail, whose work is focused on detecting cancer early, is backed by investors including tech billionaire Bill Gates and Amazon founder Jeff Bezos.

NHS England hopes the blood test will be particularly useful in identifying types of cancer that are currently difficult to diagnose and treat early.

"Early detection -- particularly for hard-to-treat conditions like ovarian and pancreatic cancer -- has the potential to save many lives," said NHS chief executive Simon Stevens.

More than 1,000 people are newly diagnosed with cancer every day in the UK, he added.

The pilot program, due to start in mid-2021, will involve 165,000 people, including 140,000 aged from 50 to 79 who have no symptoms but will have annual blood tests over three years.

The remaining 25,000 participants will be people with possible cancer symptoms who will be offered the blood test to speed up their diagnosis after they are referred to hospital in the normal way, the news release said.

Results are expected by 2023, after which it is hoped one million people could receive the test by 2025, expanding this to the wider population thereafter, NHS England said.

In England, around half of cancers are currently diagnosed at stage one or two but the NHS aims to increase that to three quarters by 2028, the news release said.

Grail said in a press release that according to modeling data, "adding Galleri to existing standard of care has the potential to decrease the number of cancers diagnosed at late stage by nearly half, which could reduce the total number of cancer deaths in the UK by approximately one-fifth."

Five-year relative survival for cancer in the UK is below the European average, according to charity Cancer Research UK.

Lawrence Young, professor of Molecular Oncology at the University of Warwick, said the Galleri test was one of a number of novel blood tests being developed to detect cancer at a very early stage when it is more easily treated.

"There are a number of trials evaluating this approach and a publication from the Circulating Cell-free Genome Atlas (CCGA) consortium examining the Galleri test in 6,689 participants has generated very encouraging results in more than 50 different cancers at different stages of development," he told the Science Media Centre.

However, not all cancer experts agree that the NHS should be piloting the Galleri blood test.

Paul Pharoah, professor of Cancer Epidemiology at the University of Cambridge, told the Science Media Centre he had doubts about the scientific basis for the pilot based on the limited published research available.

"The Galleri blood test is a test that might be able to detect cancer in the blood in individuals with early cancer, though the evidence that it does this effectively is weak," he said. "The NHS should not be investing in such a test before it has been adequately evaluated in well-conducted, large-scale clinical trials."

Michelle Mitchell, Cancer Research UK's chief executive, said tests such as that developed by Grail had "great transformative potential" if they prove effective in detecting cancer earlier.
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Dr. Jodie Moffat, head of early diagnosis at Cancer Research UK, said results so far from studies outside the UK had been promising. "But the sample sizes, particularly for some cancer types, have been very small and so it needs to be tested in a much larger sample, and with longer follow up of patients not testing positive with the blood test to understand where it is missing cancers," she told the Science Media Centre.

"Based on the evidence we have seen, the test is not currently that good at picking up stage I cancer, where it is small and hasn't spread to other parts of the body."

Source: CNN Health

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Italy orders bars and restaurants to close early as COVID rates surge

25/10/2020

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Italy on Sunday ordered bars and restaurants to close by 6 p.m. and shut public gyms, cinemas and swimming pools to try to halt a rapid resurgence in the coronavirus that has pushed daily infection rates to new records.

The measures, which take effect on Monday and were agreed between Prime Minister Giuseppe Conte’s government in Rome and regional authorities, arrived after two nights of protests in Naples and Rome against curfews introduced in a number of regions last week.

Aware of the huge cost of shutting down the economy, the Rome government has said it does not want to repeat the blanket lockdown ordered in the first phase of the crisis. But it has been forced to ratchet up restrictions steadily as the pandemic has raced ahead after slowing down in the summer.

The decree encourages people not to go out and to limit contacts at home with anyone outside their immediate family, but does not impose a mandatory nationwide curfew or lockdown and allows shops and most businesses to remain open.

However, service in bars and restaurants will be subject to a series of controls to limit contagion, and cinemas, theatres, gaming halls and disotheques will be closed.

The decree also directs that up to three quarters of high school teaching should be done online to limit the number of pupils in school buildings.

Italy, once the country hardest hit by the pandemic in the industrialised world, has been overtaken by others in Europe including Spain, France and Britain, but case rates have been rebounding rapidly and health services have come under increasing pressure.

On Saturday, authorities reported a new record daily total of 19,644 infections, as well as 151 deaths from the respiratory disease.

The protests in Naples and Rome, while limited in scale, underlined the tense political climate facing Conte’s coalition government between the anti-establishment 5 Star Movement and the centre-left Democratic Party.

Conte was generally praised for his handling of the initial phase of the crisis but has come under increasing fire for failing to strengthen preparations including testing and contact tracing over the summer.

Source: Reuters

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Mouthwashes, oral rinses may inactivate human coronaviruses

23/10/2020

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PicturePenn State College of Medicine researchers say certain oral antiseptics and mouthwashes may have the ability to inactivate human coronaviruses. They say clinical trials needed to determine if these products can reduce the amount of virus COVID-19 positive patients spread when talking, sneezing or coughing. IMAGE: GETTY IMAGES | JAE YOUNG JU


Certain oral antiseptics and mouthwashes may have the ability to inactivate human coronaviruses, according to a Penn State College of Medicine research study. The results indicate that some of these products might be useful for reducing the viral load, or amount of virus, in the mouth after infection and may help to reduce the spread of SARS-CoV-2, the coronavirus that causes COVID-19.

Craig Meyers, distinguished professor of microbiology and immunology and obstetrics and gynecology, led a group of physicians and scientists who tested several oral and nasopharyngeal rinses in a laboratory setting for their ability to inactivate human coronaviruses, which are similar in structure to SARS-CoV-2. The products evaluated include a 1% solution of baby shampoo, a neti pot, peroxide sore-mouth cleansers, and mouthwashes.

The researchers found that several of the nasal and oral rinses had a strong ability to neutralize human coronavirus, which suggests that these products may have the potential to reduce the amount of virus spread by people who are COVID-19-positive.

“While we wait for a vaccine to be developed, methods to reduce transmission are needed,” Meyers said. “The products we tested are readily available and often already part of people’s daily routines.”

Meyers and colleagues used a test to replicate the interaction of the virus in the nasal and oral cavities with the rinses and mouthwashes. Nasal and oral cavities are major points of entry and transmission for human coronaviruses. They treated solutions containing a strain of human coronavirus, which served as a readily available and genetically similar alternative for SARS-CoV-2, with the baby shampoo solutions, various peroxide antiseptic rinses and various brands of mouthwash. They allowed the solutions to interact with the virus for 30 seconds, one minute and two minutes, before diluting the solutions to prevent further virus inactivation. According to Meyers, the outer envelopes of the human coronavirus tested and SARS-CoV-2 are genetically similar so the research team hypothesizes that a similar amount of SARS-CoV-2 may be inactivated upon exposure to the solution.

To measure how much virus was inactivated, the researchers placed the diluted solutions in contact with cultured human cells. They counted how many cells remained alive after a few days of exposure to the viral solution and used that number to calculate the amount of human coronavirus that was inactivated as a result of exposure to the mouthwash or oral rinse that was tested. The results were published in the Journal of Medical Virology.

The 1% baby shampoo solution, which is often used by head and neck doctors to rinse the sinuses, inactivated greater than 99.9% of human coronavirus after a two-minute contact time. Several of the mouthwash and gargle products also were effective at inactivating the infectious virus. Many inactivated greater than 99.9% of virus after only 30 seconds of contact time and some inactivated 99.99% of the virus after 30 seconds.   

According to Meyers, the results with mouthwashes are promising and add to the findings of a study showing that certain types of oral rinses could inactivate SARS-CoV-2 in similar experimental conditions. In addition to evaluating the solutions at longer contact times, they studied over-the-counter products and nasal rinses that were not evaluated in the other study. Meyers said the next step to expand upon these results is to design and conduct clinical trials that evaluate whether products like mouthwashes can effectively reduce viral load in COVID-19-positive patients.

“People who test positive for COVID-19 and return home to quarantine may possibly transmit the virus to those they live with,” said Meyers, a researcher at Penn State Cancer Institute. “Certain professions including dentists and other health care workers are at a constant risk of exposure. Clinical trials are needed to determine if these products can reduce the amount of virus COVID-positive patients or those with high-risk occupations may spread while talking, coughing or sneezing. Even if the use of these solutions could reduce transmission by 50%, it would have a major impact.”

Future studies may include a continued investigation of products that inactive human coronaviruses and what specific ingredients in the solutions tested inactivate the virus.

Janice Milici, Samina Alam, David Quillen, David Goldenberg and Rena Kass of Penn State College of Medicine and Richard Robison of Brigham Young University also contributed to this research.
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The research was supported by funds from Penn State Huck Institutes for the Life Sciences. The researchers declare no conflict of interest.

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Hospitalized coronavirus patients who take daily aspirin have lower death risk, study finds

23/10/2020

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PictureThose who took aspirin also had a 47% reduced risk of dying in the hospital compared to those who did not take the drug. (iStock)
Hospitalized coronavirus patients who took daily aspirin for cardiovascular health had a lower death risk than those who did not take aspirin, according to the findings of a new study conducted by researchers with the University of Maryland School of Medicine. 

Patients who took aspirin also had a lower risk of complications, while their chances of requiring admission into the hospital’s intensive care unit (ICU) and being ventilated also fell, according to a news release regarding the findings, which were published Wednesday in the journal Anesthesia and Analgesia. 

For the study, the team looked at the medical records of some 412 patients who were hospitalized due to complications with COVID-19. The average age of patients was 55. All patients in the study were treated at the University of Maryland Medical Center in Baltimore or three other hospitals along the East Coast, per the release. Any of the patients’ preexisting conditions, such as hypertension, diabetes, kidney disease, and others, as well as age, gender, body mass index and race, were all accounted for in the study. 

Roughly a quarter of the patients were taking daily, low-dose aspirin before they were admitted or began taking the drug shortly after they were admitted to the hospital.

Following their analysis, the study authors concluded that those who took aspirin had a 44% reduced chance of requiring ventilation, and a 43% less risk of requiring admission into the ICU. Most importantly, the researchers said, those who took aspirin also had a 47% reduced risk of dying in the hospital compared to those who did not take the drug. 

“The patients in the aspirin group did not experience a significant increase in adverse events such as major bleeding while hospitalized,” they added. (Daily use of low-dose aspirin, which is often recommended for those who have previously suffered a heart attack or stroke to prevent future blood clots, can increase the risk “of major bleeding or peptic ulcer disease,” the researchers explained.)

The researchers hypothesize that aspirin’s blood-thinning effects may have played a role in the positive outcomes for hospitalized patients taking the drug, as COVID-19 infections “increase the risk of dangerous blood clots that can form in the heart, lungs, blood vessels and other organs. Complications from blood clots can, in rare cases, cause heart attacks, strokes and multiple organ failure as well as death,” they said.

“This is a critical finding that needs to be confirmed through a randomized clinical trial,” said study leader Dr. Jonathan Chow, an assistant professor of anesthesiology at the University of Maryland School of Medicine, in a statement. “If our finding is confirmed, it would make aspirin the first widely available, over-the-counter medication to reduce mortality in COVID-19 patients.”

​The researchers in the study also noted that the findings provide “cautious optimism,” but warned any COVID-19 patients should speak with their doctor before taking daily aspirin, as those who suffer from chronic kidney disease or use other medications such as blood thinners may not be able to take the drug. 

“While confirmatory studies are needed to prove that aspirin use leads to better outcomes in COVID-19, the evidence thus far suggests that patients may want to discuss with their doctor whether it is safe for them to take aspirin to manage potentially prevent serious complications,” said the Dr. E. Albert Reece, the executive vice president for Medical Affairs, UM Baltimore, and the John Z. and Akiko K. Bowers distinguished professor and dean at the University of Maryland School of Medicine, in a statement. 

​Source: Foxnews

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A second pathway into cells for SARS-CoV-2: New understanding of the neuropilin-1 protein could speed vaccine research

23/10/2020

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PictureThe Spike protein on the surface of SARS-CoV-2 must bind to proteins on the surface of human cells to trigger an infection


​When it comes to how the coronavirus invades a cell, it takes three to tango. The dance began with the ACE2 receptor, a protein on human cells that allows SARS-CoV-2, the virus that causes COVID-19, to enter and infect the cell. But now enter a new dance partner – another protein – that is present on human cells. This tango of three proteins – two human and one viral – enhances the ability of SARS-CoV-2 to enter human cells, replicate and cause disease.

COVID-19 has crippled health care systems and economies worldwide. Extraordinary efforts are underway to develop vaccines and other therapies to combat this virus. But for these efforts to succeed, understanding how the virus enters cells is critical. To that end, in two papers published in Science, two teams independently discovered that a protein called the neuropilin-1 receptor is an alternative doorway for SARS-CoV-2 to enter and infect human cells. This is a major breakthrough and a surprise, because scientists thought neuropilin-1 played roles in helping neurons make the correct connections and aiding the growth of blood vessels. Before this new research, no one suspected that neuropilin-1 could be a door for SARS-CoV-2 to enter the nervous system.

My colleagues and I were particularly intrigued by these reports because as neuroscientists who study how pain signals are triggered and transmitted to the brain, we were also probing the activity of neuropilin-1. In a recent paper our team showed how neuropilin-1 is involved with pain signals and how, when the SARS-CoV-2 virus attaches to it, it blocks pain transmission and relieves pain. The new work shows that neuropilin-1 is an independent doorway for the COVID-19 virus to infect cells. This discovery provides insights that may reveal ways to block the virus.

Neuropilin-1 helps SARS-CoV-2 get in

A protein called Spike that sits on the outer surface of SARS-CoV-2 allows this virus to attach to protein receptors of human cells. Recognizing that a tiny piece of Spike was similar to regions of human protein sequences known to bind to neuropilin receptors, both research teams realized that neuropilin-1 may be critical for infecting cells.

Using a technique called X-ray crystallography, which allows researchers to see the three-dimensional structure of the Spike protein at a resolution of individual atoms, as well as other biochemical approaches, James L. Daly of the University of Bristol and colleagues showed that this short sequence from Spike attached to neuropilin-1.

In experiments in the lab, the SARS-CoV-2 virus was able to infect fewer human cells that lacked neuropilin-1.

In cells with both the ACE2 and neuropilin-1 proteins, SARS-CoV-2 infection was greater compared to cells with either “doorway” alone.

Daly and colleagues showed that SARS-CoV-2 was able to infect fewer cells if they used a small molecule called EG00229 or antibodies to block the Spike protein’s access to neuropilin-1.

Neuropilin-1 receptor helps virus infect cells.

Using similar methods, a team led by German and Finnish researchers came to the same conclusions as the first study. Specifically, this team showed that neuropilin-1 was critical for the SARS-CoV-2 virus to enter and infect cells.

By using an antibody to block one region of the neuropilin-1 receptor protein, the researchers showed that SARS-CoV-2 harvested from COVID-19 patients could not infect cells.

In another experiment, Ludovico Cantuti-Castelvetri of the Technical University Munich and colleagues attached silver particles to synthetic Spike proteins made in the lab and found that these particles were able to enter cells that carried neuropilin-1 on their surfaces. When they did the same experiments in live mice, they found that the silver particles entered cells lining the nose. The researchers were surprised to discover the Spike protein could also enter neurons and blood vessels within the brain.

Neuropilin-1 receptor helps virus infect cellsUsing tissues from human autopsies, Cantuti-Castelvetri and colleagues noted that neuropilin-1 was present in the cells lining the human respiratory and nasal passages, while the ACE2 protein was not. This demonstrates that neuropilin-1 provides an independent doorway for the COVID-19 virus to infect the cells.

Moreover, cells lining the nasal passages from COVID-19 patients that were positive for neuropilin-1 were also positive for the Spike protein. These findings confirmed that Spike uses the neuropilin-1 protein to infect human cells in regions of the body where ACE2 isn’t present.
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​Neuropilin-1 can block viruses, cancer and pain

In a surprising discovery recently reported by our lab, we found that the SARS-CoV-2 Spike protein has a pain-relieving effect. Even more surprising was the finding that this analgesia involved the neuropilin 1 receptor.

We demonstrated that Spike prevented a protein from binding to neuropilin-1, which blocked pain signals and brought pain relief. That is because when this protein, called Vascular Endothelial Growth Factor A (VEGF-A) – which is produced by many cells in the body – binds to neuropilin-1 under normal circumstances, it initiates the process of pain signaling by exciting neurons that convey pain messages.

So, the virus revealed to us a potential new target – the neuropilin-1 receptor – for managing chronic pain. Now if we can decipher how neuropilin-1 contributes to pain signaling, then we be able to target it to design ways to block pain.
In our lab, we are now taking advantage of how Spike engages neuropilin-1 to design new pain inhibitors. In this report on the preprint server BioRxiv, we have identified a series of novel compounds that bind to neuropilin-1 in a manner that mimics Spike. These molecules have the potential to interfere with neuropilin-1 function including SARS-CoV-2 virus entry, and block pain signals and even cancer growth.

More dance partners to come

The studies by Daly and colleagues and Cantuti-Castelvetri and colleagues shift our collective focus onto neuropilin-1 as a potential new target for COVID-19 therapies.

These studies also have implications for the development of vaccines against the Spike protein. Perhaps the most important implication is that the neuropilin-1 binding region of Spike should be targeted for COVID-19 prevention. Because a number of other human viruses, including Ebola, HIV-1 and highly virulent strains of avian influenza, also share this signature sequence of Spike, neuropilin-1 may be a promiscuous mediator of viral entry.

But it appears that the tango is not over yet. More dance partners have emerged. PIKFyve kinase and CD147 – two proteins – have also been shown to bind Spike and facilitate viral entry. Whether these new partners take center stage or play second fiddle to ACE2 and neuropilin-1 remains to be seen.

Source: The Conversation


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UK scientific advisor says coronavirus unlikely to be eradicated

21/10/2020

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​LONDON (Reuters) - The coronavirus will be around for “evermore” as it is unlikely it will be eradicated, a British scientist on the government’s advisory committee for the pandemic said on Wednesday, although a vaccine would help improve the situation.

Britain, like other countries in Europe, is currently in the grip of a resurgence in COVID-19 infections, with much of the country under local restrictions and more than 21,000 daily cases reported on Tuesday.

“We are going to have to live with this virus for evermore. There is very little chance that it’s going to become eradicated,” John Edmunds, a member of Scientific Advisory Group for Emergencies (SAGE), told lawmakers.

Although the coronavirus will be around indefinitely, Edmunds said that the prospect of a vaccine towards the end of the winter should impact the government’s strategy now.

“If vaccines are just around the corner then, in my view, we should try and keep the incidence as low as we can now, because we will be able to use vaccines in the not too distant future,” he said.

He said the UK had played a “clever game” in investing in different coronavirus vaccines. Britain has signed supply deals for six different COVID-19 vaccines, with 340 million doses secured across different types of technologies.
“I think we will be in a reasonable position in months,” he said. “I don’t think we’re going to be vaccinating everybody but to start, maybe the highest risk people, healthcare workers and so on.”

Reporting by Alistair Smout; editing by William James and Michael Holden

​Source: Reuters 

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AstraZeneca COVID-19 vaccine trial Brazil volunteer dies, trial to continue

21/10/2020

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PictureFILE PHOTO: A test tube labelled vaccine is seen in front of AstraZeneca logo in this illustration taken, September 9, 2020. REUTERS/Dado Ruvic/Illustration/File Photo/File Photo

Brazilian health authority Anvisa said on Wednesday that a volunteer in a clinical trial of the COVID-19 vaccine developed by AstraZeneca and Oxford University had died but added that the trial would continue.

Oxford confirmed the plan to keep testing, saying in a statement that after careful assessment “there have been no concerns about safety of the clinical trial.”

AstraZeneca declined to comment immediately.

A source familiar with the matter told Reuters the trial would have been suspended if the volunteer who died had received the COVID-19 vaccine, suggesting the person was part of the control group that was given a meningitis jab.

The Federal University of Sao Paulo, which is helping coordinate phase 3 clinical trials in Brazil, said an independent review committee had also recommended the trial continue. The university earlier confirmed the volunteer was Brazilian but gave no further personal details.

“Everything is proceeding as expected, without any record of serious vaccine-related complications involving any of the participating volunteers,” the Brazilian university said in a statement.

So far, 8,000 of the planned 10,000 volunteers in the trial have been recruited and given the first dose in six cities in Brazil, and many have already received the second shot, said a university spokesman.

CNN Brasil reported that the volunteer was a 28-year-old man who lived in Rio de Janeiro and died from COVID-19 complications.

Anvisa provided no further details, citing medical confidentiality of those involved in trials.
AstraZeneca shares fell 1.8%.

Brazil’s federal government has plans to purchase the UK vaccine and produce it at biomedical research center FioCruz in Rio de Janeiro, while a competing vaccine from China’s Sinovac Biotech Ltd is being tested by Sao Paulo state’s research center Butantan Institute.

Brazil’s President Jair Bolsonaro said on Wednesday the federal government will not buy the Sinovac vaccine.

Brazil has the second deadliest outbreak of the coronavirus, after the United States, with more than 154,000 killed. It has the third largest number of cases, with more than 5.2 million infected, after the United States and India.



Reporting by Eduardo Simoes in Sao Paulo and Ludwig Burger in Frankfurt; additional reporting by Ricardo Brito and Anthony Boadle in Brasilia and Alistair Smout in London; writing by Jake Spring; editing by Jonathan Oatis and Rosalba O’Brien

Source: Reuters

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98 Symptoms Coronavirus Patients Say They've Had"Long haulers" report a wide variety of painful side effects from COVID-19.

20/10/2020

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Ever since COVID-19 reared its ugly head and upended our world, long-lasting symptoms of the virus have been varied and hard to pinpoint—until now. "A survey conducted by Dr. Natalie Lambert of Indiana University School of Medicine and Survivor Corps analyzed the long-term experiences COVID-19 survivors are having with the virus. The COVID-19 'Long Hauler' Symptoms Survey Report identified 98 long-lasting symptoms." Click through from least common to most common to see if you've experienced any. Read on, and to ensure your health and the health of others.

98 Syncope
Syncope is when you faint or pass out, usually due to a temporary drop in blood flow to the brain, reports the Cleveland Clinic. One study published in the journal Heart Rhythm Case Reports finds syncope may be the presenting symptom of a COVID-19 infection, even in those who are asymptomatic. "Recognizing this possibility is of extreme importance, especially in the initial phase of COVID-19 infection," warn the researchers.

97 Bilateral Neck Throbbing Around Lymph Nodes
When lymph nodes throb or swell, it's a sign of trauma around the neck area, an infection, or a bacterial illness related to a cold or sore throat, reports Health Link British Columbia. COVID-19 is generally known as a respiratory virus that can also affect your throat and sinuses. 

96 Elevated ThyroidYour thyroid is an essential element to your body's proper functionality. According to Informed Health, it "plays a major role in the metabolism, growth and development of the human body." It does this by releasing the perfect amount of thyroid hormones at the perfect times. Some COVID-19 sufferers report having elevated thyroid levels as a long-lasting symptom of the virus.

95 Anemia
Anemia is "a condition in which you lack enough healthy red blood cells to carry adequate oxygen to your body's tissues," says the Mayo Clinic. The most common type of anemia is associated with not getting enough iron. The condition makes you feel tired and weak. In some cases, it may even cause chest pain and dizziness, which are common long-lasting symptoms of coronavirus. 

94 Herpes, EBV, or Trigeminal Neuralgia

The symptoms of herpes, Epstein-Barr Virus (EBV), and trigeminal neuralgia are varied and may include fatigue, inflamed throat, fever, and facial pain. These are also common symptoms of COVID-19 and 38 sufferers who participated in the survey reported experiencing symptoms of these conditions after the virus was gone.

93 GERD With Excessive Salivation

GERD is acid reflux and it's commonly known to cause excessive salivation, or drooling. According to University of Florida Health, trauma or infections in the throat, such as sinus infections or swollen adenoids, can cause GERD, which may lead to drooling. 

92 Personality Change (Drastic)

Scientists are studying the rare but potentially severe personality changes that COVID-19 may cause in patients. According to an article published in Science News, symptoms related to the brain are often overlooked as medical professionals focus on the physical aspects of the virus.  However, depression, personality changes, and confusion are some long-lasting symptoms that some COVID-19 sufferers may experience.

91 Thrush

Thrush is small, white lesions inside your mouth caused by an imbalance of bacterial growth, more specifically an overgrowth of Candida, according to Cedars-Sinai. Some people are more prone to developing thrush but it may also be common with COVID-19 survivors. Since the virus affects your respiratory system and throat, imbalances in the mouth and tongue may also occur. 

90 Hormone Imbalances

Your hormones are important because they regulate your appetite, mood, sexual function, and body temperature. According to Women in Balance Institute, a hormone imbalance may be caused by stress, an unhealthy lifestyle, or a buildup of toxins in the body.  COVID-19 sufferers may experience this imbalance as the virus wreaks havoc on their respiratory system and as their immune system works hard to fight it off. 

89 UTI

A urinary tract infection occurs when germs get into the urethra and begin to spread throughout the urinary tract, says to John Hopkins Medicine. One study published in Elsevier Public Health Emergency Collection "found a potentially dangerous overlap of classical urinary symptoms and the as yet not fully described symptoms of COVID-19." Urinary frequency and the virus may be related, which explains its potential cause of UTIs in patients.

88 Kidney Issues or Protein in Urine

Kidney issues, including protein in the urine, was a long-lasting symptom of COVID-19 for 47 survey participants. The specific ways the virus affects kidneys isn't known yet, but according to John Hopkins Medicine, it may invade kidney cells or the low levels of oxygen the virus causes may be what contribute to these long-lasting kidney problems.

87 Dry Scalp or Dandruff

While it's not a serious issue, dry scalp and dandruff can be uncomfortable and embarrassing. According to Cedars-Sinai, dandruff can be caused by changes in hormones, so it makes sense that it's related to the virus. 

86 Low Blood Pressure
There are many causes of low blood pressure, such as genetics, your diet, or dehydration. According to the Mayo Clinic, low blood pressure is also related to infections and hormone fluctuations, which is why it may be a long-lasting symptom of COVID-19. 

85 Covid Toes

"COVID toes" are an emerging symptom of the virus that may not be as common as the other symptoms, such as cough or fever. COVID toes occur when the toes develop a rash or lesions. According to Dr. Humberto Choi, MD, from the Cleveland Clinic, rashes on the skin are common with viral infections such as COVID-19. The survey found that 59 participants had this strange side effect after being infected with coronavirus. 

84 Eye Stye or Infection

According to the University of Miami, it's possible that coronavirus could cause an eye infection, such as conjunctivitis, also known as pinkeye. The American Academy of Ophthalmology concludes that styes are caused by bacterial infections, which could explain the relationship to this eye condition and the virus. 

83 Foot Pain

Foot pain can be caused by a number of ailments, such as corns, plantar fasciitis, or achilles tendon injuries. "Covid toes" may contribute to this pain since some patients can have trouble walking or sleeping due to lesions on their toes. In most cases, this strange symptom goes away so the foot pain should also subside.

82 Goiter or Lump in Throat

A goiter is an "abnormal enlargement of the thyroid gland," according to the American Thyroid Association. While a goiter doesn't necessarily mean the thyroid isn't functioning correctly, it does indicate that there's a potential hormonal imbalance causing the thyroid gland to grow abnormally. 70 survey respondents dealt with a goiter after COVID-19, possibly due to the hormonal effects the virus has on the body.

81 Cracked or Dry Lips

Cracked or dry lips can occur in especially cold or hot weather or may be a sign of dehydration. When a virus like COVID-19 takes hold, dry lips may also occur because viruses are likely to cause dehydration. The American Academy of Dermatology suggests using lip balm, drinking plenty of fluids, and refraining from picking at the dry skin to get this symptom to go away.

80 Cold Burning Feeling in Lungs

COVID-19 is a respiratory virus so it's no wonder those who contracted the illness feel a cold or burning sensation in their lungs. However, this symptom may last longer than the virus since 74 survey participants reported this feeling after coronavirus was gone. An article published in NBC News concludes that many COVID-19 sufferers felt this "slow burn" for a while, until it either worsened and was treated or went away completely

79 Low Blood Oxygen

According to the Centers for Diseases Control and Prevention (CDC), bluish lips or face is an emergency of COVID-19. When your lips turn blue, it's a sign your blood oxygen has dipped to extreme levels. The survey found that 77 participants claimed they experienced low blood oxygen after contracting coronavirus. One reason for this is that lung capacity may not have fully recovered from the respiratory virus.

78 Arrhythmia

The Mayo Clinic defines arrhythmia as a heart rhythm problem and explains it happens when "electrical impulses that coordinate your heartbeats don't work properly, causing your heart to beat too fast, too slow or irregularly." A study published in HeartRhythm studied hospitalized coronavirus patients and found some of them suffered bradyarrhythmias or cardiac arrests. The study concluded heart traumas and abnormalities like these are "likely the consequence of systemic illness and not solely the direct effects of COVID-19 infection."

77 Jaw Pain

In the survey, 80 participants reported jaw pain as a long-lasting symptom of COVID-19. According to the American Dental Association, jaw pain may be caused by bone problems, stress, infection, sinus issues, or tooth grinding. It's known that coronavirus causes aches and pains, so this jaw pain may be a lingering side effect of the body fighting off the virus.

76 Painful Scalp

For COVID-19 sufferers, a painful scalp may be a side effect of the dandruff the virus may cause or aches and pains associated with the illness. According to Kaiser Permanente, scalp pain or ailments may occur after recovering from a high fever, when dealing with a thyroid issue, or if you have poor nutrition.

75 Burning Sensations

According to an article published in St. Peter's Health Partners, a "tingling, burning, or 'fizzing' sensation" was reported from several COVID-19 patients. This sensation may be a side effect of other symptoms, such as aches and pains or fever.

74 Mid-Back Pain at Base of Ribs

According to the National Institute of Neurological Disorders and Stroke, back pain intensity can range "from a dull, constant ache to a sudden, sharp or shooting pain."  Those recovering from illness may report this pain due to a decrease in movement over the past few days or due to the usual aches and pains of their sickness. 84 survey respondents claimed mid-back pain or pain at the base of their ribs after COVID-19. It's usually treated with muscle relaxants, gentle stretching, heat, or ice.

73 Abnormally Low Temperature

After potentially experiencing a fever while fighting off COVID-19, sufferers may be surprised by the strange long-lasting symptom of a low body temperature once they've recovered. According to Kaiser Permenante, a low body temperature may occur with an infection or may be a sign of diabetes or a low thyroid level. A low temperature may also be the culprit for chills, since the body attempts to warm up with narrowed blood vessels.

72 Bulging Veins

Your veins circulate the blood around your body and when you're too cold or hot, your blood vessels may constrict or widen. This may be due to having a fever, then low body temperature, or it may be a sign of dehydration. According to the Mayo Clinic, these bulging veins may be due to inactivity or damaged blood valves.

71 Hand or Wrist Pain

Arthralgia (joint pain) is a common symptom of coronavirus and a study published in the Nature Public Health Emergency Collection found that at least one patient in the 40 that were studied experienced joint pain. This joint ailment may linger in those who had the virus, causing hand or wrist pain to remain.

70 Costochondritis

The Mayo Clinic defines costochondritis as "inflammation of the cartilage that connects a rib to the breastbone (sternum)." Cedars-Sinai claims that the risk for developing a chest wall infection like costochondritis is increased with respiratory trauma, such as pneumonia or bronchitis. Since COVID-19 is a respiratory illness, it's not surprising that 98 survey respondents who had the virus claimed costochondritis as a lingering symptom. 

69 Spikes in Blood Pressure

According to Rush University Medical Center, a spike in blood pressure could be caused by a number of factors, such as stress, thyroid problems, or certain medications. A study published by the American College of Cardiology found a potential link between the virus and the renin-angiotensin aldosterone system, which is a "critical neurohormonal pathway that regulates blood pressure and fluid balance." This may explain the changes in blood pressure these patients experienced after coronavirus. 

68 Kidney Pain

According to the National Kidney Foundation, acute kidney damage occurs in about 15% of COVID-19 patients, some of which never had kidney problems before. The survey found that 115 respondents have kidney pain after coronavirus, which may be a sign that the virus has caused kidney damage.

67 Brain Pressure

The long-term extreme effects of COVID-19 still remain a mystery, but the survey found that 119 people who had the virus suffered from brain pressure. A study published in the Journal of the Brazilian Society of Tropical Medicine found a potential link between COVID-19 and benign intracranial hypertension, a condition that causes pressure in the brain. These symptoms are usually temporary but can be serious if they get worse and are left untreated.

66 Swollen Lymph Nodes

According to the Cleveland Clinic, swollen lymph nodes are usually a sign that your body is fighting an infection. Your glands are working hard to flush out toxins and cells through lymph fluid. When your body fights a virus like COVID-19, lymph nodes may swell as all hands are on deck trying to get rid of the illness. 

65 Extreme Pressure at Base of Head or Occipital Nerve

One of the common symptoms of COVID-19 is a headache but 128 survey participants reported feeling extreme pressure at the base of their head or occipital nerve after recovering from the virus. According to the American Association of Neurological Surgeons, pressure at the occipital nerve (the nerves that run through the scalp) may be caused by muscle tightness or pinched nerves. These nerves may experience pressure or pain during an infection or due to blood vessel inflammation. 

64 Feeling of Burning Skin

According to a study published in JAMA Dermatology, the virus may be associated with a number of different skin rashes. The study found two different types of rashes that occurred in some patients infected with the coronavirus: petechial flexural eruption and digitate papulosquamous rashes. These skin conditions could occur at any time during and after infection and may contribute to the feeling of burning skin.


63 Bone Aches in Extremities

Body, joint, and bone aches are common with coronavirus and most other illnesses. According to one study, when the immune system is in overdrive, it causes an immune response that ramps up your white blood cells and causes them to produce glycoproteins called interleukins. These can cause joint pain, bone pain, and swelling.

62 Phantom Smells

According to the Mayo Clinic, this condition is called phantosmia or olfactory hallucinations and they're commonly caused by upper respiratory infections like the virus.

61 "Hot" Blood Rush

These feelings of hot blood rushing may be due to blood vessel irregularities caused by the virus or remnants of a fever. According to a study published in Science Daily, this sudden rise in temperature may be your immune system cranking up in an attempt to continue killing off the virus. The study found that "elevated body temperature helps certain types of immune cells to work better."

60 Chills But No Fever

Chills without a fever was a long-lasting COVID-19 symptom for 154 survey participants. It could be the body's way of continuing to regulate temperature and recover from a previous fever. According to Keck Medicine of USC, chills without a fever may also indicate your body is under stress and fighting a viral or bacterial infection or you're dealing with low blood sugar, which makes sense if you didn't eat much while you were sick.

59 Neck Muscle Pain

According to John Hopkins Medicine, your neck doesn't have much protection or support so neck pain is common. Since the virus is known to cause muscle and joint pain, as well as body aches, your sensitive neck is more susceptible to this lingering symptom. 

58 Mouth Sores or Sore Tongue

According to the University of Florida Health, tongue pain and soreness can be caused by a number of factors, such as infection, hypothyroidism, or a tumor in the pituitary gland. A study published in the International Journal of Infectious Diseases found that oral mucosal lesions may be associated with COVID-19 patients, which could explain this long-lasting virus symptom.

57 Heat Intolerance

According to the CDC, one of the most common symptoms of COVID-19 is a fever. The body may need time after a fever has dissipated to recover and regulate its temperature. This may be why 165 survey respondents claim to have heat intolerance after being infected with COVID-19. As the immune system fights off the virus, it raises and lowers the body's temperature accordingly, which may cause this heat intolerance to linger.

56 Swollen Hands or Feet

Those who contracted COVID-19 and experienced "COVID toes" or other skin-related symptoms may also be dealing with swollen hands and feet. According to the Mayo Clinic, this swelling is called edema and it could be linked to kidney or heart problems, both of which may be caused by coronavirus

55 Dry or Peeling Skin

Dry skin may be attributed to the rashes and cutaneous manifestations that some people develop on their skin due to the virus. However, according to the American Skin Association, dry skin may also be attributed to a decline in fluid intake, which can happen when you're sick. It may also be a telling sign of a thyroid problem or hormonal imbalance.

54 High Blood Pressure

According to A&D Medical, "High blood pressure is not a documented symptom of COVID-19, but it can exacerbate the symptoms of the virus." The 181 survey respondents who report experiencing high blood pressure after having COVID-19 likely already suffered from this condition but fighting the virus may have made it worse.

53 Dry Throat

According to the World Health Organization (WHO), COVID-19 symptoms generally include a dry cough and sore throat. Living with a dry cough and sore throat throughout the course of the virus may cause this dry throat to remain for a while, even after testing negative for COVID-19.

52 Post-Nasal Drip

Post-nasal drip is when mucus drips down the back of your throat and it's common after you've had a stuffy or runny nose. After dealing with allergy or sinus issues or infections, post-nasal drip can linger for a while. If one's body produced extra mucous and fluids in an attempt to fight off the virus, this mucus may continue to drip. According to Harvard Health Publishing, you can treat post-nasal drip by staying hydrated, taking a nasal decongestant, or inhaling steam, such as from a hot shower.

51 Weight Loss

COVID-19 survivors who had severe cases are likely to experience extreme weight loss. According to an article posted by Northeast Ohio Medical University, it's common for patients who survive severe infections or illnesses to lose weight. When sufferers are placed on ventilators or hospitalized for long periods of time, their bodies don't obtain the proper nutrition or muscle-building exercise. The body is also under stress fighting off the virus, which can cause this weight loss to occur.

50 Feeling Irritable

According to MedPage Today, it's not uncommon for patients recovering from COVID-19 to feel irritable or angry. The virus may have mental health effects that make it hard for those who have recovered to go back to work or their daily routine without mood swings. Patients who were hospitalized may experience irritation and symptoms similar to post-traumatic stress disorder (PTSD) after being released.

49 Muscle Twitching

According to the University of Florida Health, muscle twitches may be caused by stress, lack of nutrients, or lack of sleep. Coronavirus is known to make its sufferers tired and their bodies stressed from fighting the virus, so this may explain muscle twitching. In some cases, it may be a sign of muscle damage or nervous system disorders.

48 Confusion

Mild confusion or "brain fog" is a common symptom of coronavirus and most colds, flues, and viruses. According to an article published in Science Magazine, this confusion may occur because the body's systems are focused on fighting the illness, not giving enough focus, blood, or alertness to the brain.

47 Sharp or Sudden Chest Pain

According to the CDC, persistent pressure or pain in the chest is a symptom of COVID-19 and 210 survey participants claim to continue feeling this symptom after the virus is gone. As a respiratory virus, it's possible that this pain or pressure is actually being felt in the lungs. However, according to Diagnostic and Interventional Cardiology, stroke, heart failure, arrhythmias, and other cardiac events have also been linked to coronavirus so sufferers should take this lingering symptom seriously.

46 Changed Sense of Taste

A loss of sense of taste is a common symptom of COVID-19 but 221 survey respondents claim the virus may have completely changed their sense of taste.  According to Kaiser Permanente, a loss of sense of taste or partial loss may cause tastes to change. These changes may also be caused by a decrease in taste buds or changes in the way the nervous system processes certain taste sensations.

45 Tinnitus or Humming in Ears

Tinnitus is a ringing or noise in the ear and 233 survey respondents claim they now experience this ringing or humming in the ears after recovering from COVID-19. According to the American Tinnitus Association, the onset of tinnitus may occur due to stress and anxiety, after there's been damage to the inner ear, or when other conditions or diseases are developed.

44 Nerve Sensations

According to a study published in the Elsevier Public Health Emergency Collection, "Viral infections have detrimental impacts on neurological functions, and even cause severe neurological damage." 243 survey participants reported feeling nerve sensations after COVID-19, which may be due to neurological damage caused by the virus. 

43 Constant Thirst

When you contract an illness or a virus like coronavirus, your body's working overtime to fight it. According to the Mayo Clinic, your body needs more fluids when you're sick and if it doesn't get the fluids, you're likely to suffer from constant thirst. It's your body's way of telling you it's not getting enough fluids to continue fighting and recovering from the virus.

42 Rash

In some COVID-19 cases, patients have developed rashes on their skin. According to a research letter published in the JAMA Network, some coronavirus patients suffered from enanthem, a skin rash that looks like small white spots on the mucous membranes.  Other patients had widespread urticaria, or hives, on their skin. Other rashes were also found in some COVID-19 patients who were studied. Scientists aren't sure if this side effect is directly related to the virus or attributed to certain medications.

41 Floaters or Flashes of Light in Vision

According to UCLA Health, "floaters" are little specks or lines that float around in your field of vision every once in a while. If you constantly see floaters or they're accompanied by flashes of light, it may indicate you have a retina tear or vitreous detachment, which occurs when vitreous gel in the eye separates from the retina. In the survey, 249 respondents claimed to suffer from floaters or flashes of light in their vision after COVID-19

40 Upper Back Pain

As with most illnesses, coronavirus is associated with muscle aches and pains. Patients with COVID-19 who were bedridden or spent an extended period of time inactive may experience upper back pain due to immobility. According to Kaiser Permanente, upper back pain isn't as common as lower back pain but may be caused by muscle strain, poor posture, or pressure on the spinal nerves.

39 Sleeping More Than Normal

Fatigue is a common symptom of coronavirus but some sufferers are having trouble shaking off that tiredness. According to an article published in The Scientist, it's possible that COVID-19 may lead to chronic illness, including chronic fatigue. Scientists are tracking these symptoms amongst sufferers who seek treatment so they can get a grasp on what other symptoms may lead to chronic illness.

38 Tremors or Shakiness

According to Northwestern Medicine, tremors may be caused by stress, anxiety, or too much caffeine. Tremors or shakes when you pick up a glass of water or hold a piece of paper may also indicate that you have essential tremor (ET), which is a neurological disorder that causes these shakes. These tremors may occur because the body is recovering from the stress of the virus, they may indicate ET, or there may be another underlying cause.


37 Calf Cramps
According to the University of Rochester Medical Center, muscle cramps usually occur after heavy exercise, when you're experiencing muscle fatigue, or if your body's dehydrated. Since the virus and other illnesses are notorious for dehydrating your body and causing muscle fatigue, these calf cramps may be an explainable symptom of coronavirus. Massaging, stretching, and warm compresses could help mitigate these cramps.


36 Dry Eyes

An article published in Review of Optometry reviewed the relationship between ocular symptoms and coronavirus in Chinese patients. It found that 27% of those studied complained of itchy, dry, and red eyes. Some even began to develop sore and dry eyes a few days before any other COVID-19 symptoms. Researchers feel this may be because coronavirus "infects the mucosa membrane epithelium and even lymphocytes, which are both abundant in ocular surface tissue."

35 Clogged Ears

According to the Mayo Clinic, when your ears are clogged "your eustachian tubes — which run between your middle ear and the back of your nose — become obstructed." It may cause pressure, ear pain, muffled hearing, or dizziness. The survey found that 267 participants experienced clogged ears as a long-lasting symptom of COVID-19. Since clogged ears are common with a stuffy nose and other respiratory illnesses or sinus infections, it's a common symptom of coronavirus. To relieve pressure, you can try popping your ears or taking a nasal decongestant.

34 Weight Gain

While weight gain isn't a symptom of the virus, stress from getting sick, lockdown and quarantine may be to blame for the extra pounds. A study published in the Journal of Translational Medicine analyzed italian citizens placed on strict lockdown and observed their lifestyle and eating habit changes. It found that 48.6% of the population studied gained weight. While the virus itself may not be to blame for this side effect, the stress and anxiety of lifestyle changes could be.

33 Nausea or Vomiting

While it's not usually listed as a common symptom of COVID-19, many who got the virus also suffered from nausea, vomiting, diarrhea, or other gastrointestinal problems. The survey found that 314 respondents claimed they still suffered from nausea or vomiting after coronavirus. According to the Mayo Clinic, these gastrointestinal symptoms were varied and some felt them well before a diagnosis. Others only dealt with these symptoms for one day.

32 Shortness of Breath or Exhaustion From Bending Over

Shortness of breath is a common symptom of COVID-19 but 318 survey participants reported that they continued to feel shortness of breath or exhaustion when they bent over. According to Penn Medicine, this may be a sign of an ongoing pulmonary problem or heart problem. While shortness of breath is common with COVID-19 sufferers, those who have recovered should seek medical attention if this symptom doesn't seem to be going away.

31 Lower Back Pain

COVID-19 causes myalgia, pain in a muscle or a group of muscles. An article published in Nature Public Health Emergency Collection concludes that myalgia in COVID-19 patients lingers longer than it may with other illnesses. Lower back pain is usually associated with pneumonia or poor lung function and since COVID-19 is a respiratory virus, it makes sense that patients are more likely to experience this type of muscle pain.

30 Abdominal Pain

While not a common symptom of COVID-19, many who contracted the virus did report gastrointestinal problems. This could explain why 344 survey respondents reported dealing with abdominal pain well after contracting the virus. In a study published through the American Gastrological Association, 31.9% of COVID-19 patients studied claimed to have gastrointestinal problems associated with the virus. 

29 Phlegm in Back of Throat

While a dry cough is most commonly associated with coronavirus, some patients may experience phlegm in the back of their throat during the later stages. For coronavirus patients dealing with phlegm, the University of Maryland Medical System suggests taking an expectorant to help get the mucus out and make your cough more productive. Staying hydrated and drinking warm beverages may also help to break up the phlegm. 

28 Partial or Complete Loss of Sense of Taste

Loss of taste, called ageusia, and loss of smell, called anosmia, are common symptoms of the virus and the duration of these symptoms  varies by patient. A study published in the Journal of Korean Medical Science analyzed Korean COVID-19 sufferers and the duration of this specific symptom. The study found that, "Most patients with anosmia or ageusia recovered within 3 weeks."

27 Changing Symptoms

As COVID-19 takes its course, patients may report symptoms that change frequently. For example, a patient may begin experiencing a headache and fever, then move onto shortness of breath and muscle aches. According to the CDC, "U.S. COVID-19 patients report a wide range of symptoms across a spectrum of illness severity."


26 Reflux or Heartburn

"Heartburn occurs when stomach acid backs up into the tube that carries food from your mouth to your stomach (esophagus)," according to the Mayo Clinic. Since the virus is known to cause gastrointestinal problems, some patients may take longer to recover from these inconsistencies than others. Avoiding alcohol, spicy foods, and large meals may help curb these long-lasting symptoms.

25 Neuropathy in Feet and Hands

Neuropathy is weakness or numbness due to nerve damage. Since the virus can do some damage to the nervous system, this may be a lingering symptom for some sufferers. According to a report published in the Elsevier Public Health Emergency Collection, COVID-19 may even disguise itself as motor peripheral neuropathy without other symptoms. Nerve fibers may be more sensitive when a patient is infected with the virus, causing this numbing of the hands and feet.

24 Sadness

As a pandemic, COVID-19 sufferers are required to quarantine, which may mean isolating from loved ones and not being able to engage in activities they enjoy. A study published in The Lancet analyzed mental side effects of the virus and concluded that medical professionals should watch their patients for signs of depression or some neuropsychiatric syndromes well after recovery.

23 Congested or Runny Nose

According to the American Pharmacists Association, the CDC recently added "runny nose" as a symptom of COVID-19. 414 survey respondents claimed a congested or runny nose as a lingering symptom of the virus. A runny nose is one way to get rid of the mucus in your body after the virus, so it may persist until the mucus is gone.


22 Blurry Vision

Blurry vision may be a sign of nerve damage or may also occur when other COVID-19 symptoms are going strong, such as a fever or headache. According to the American Academy of Ophthalmology, blurred vision may also be a symptom of endophthalmitis, which is an infection of tissue or fluids inside the eye. If this is the case, quick treatment is required to prevent blindness.

21 Hair Loss

According to Dr. Shilpi Khetarpal, MD from the Cleveland Clinic, hair loss isn't necessarily a symptom of COVID-19 but may be a side effect of the virus. She states, "We are seeing patients who had COVID-19 two to three months ago and are now experiencing hair loss." In the survey, 423 respondents reported experiencing hair loss after coronavirus. Dr. Khetarpal says this may be due to a change in diet, high fever, extreme weight loss, or any other "shock to the system" that COVID-19 may have caused.

20 Fever or Chills

The CDC conducted a study on coronavirus patients and found that 96% of patients recovered from chills and 97% recovered from fever. While most recovered from all COVID-19 symptoms, 34% still revealed that they were suffering from one or more lasting symptoms when interviewed four to eight days after testing positive. 65% of sufferers returned to their usual state of health around seven days after testing positive but chronic medical conditions, age, weight, gender, and other factors may affect how long symptoms, such as fever and chills, last.


19 Tachycardia

According to the Mayo Clinic, tachycardia occurs when your heart beats over 100 beats per minute. It's a form of arrhythmia, or a heartbeat disorder. In the survey, 448 respondents experienced tachycardia after suffering from COVID-19. It may be the body's response to stress, trauma, or illness. However, if tachycardia is left untreated and continues to occur, it can lead to serious complications, such as heart failure or stroke.

18 Partial or Complete Loss of Sense of Smell

Partial or complete loss of sense of smell is a common symptom with COVID-19 and many other respiratory viruses, according to Penn Medicine. Since your olfactory system is so close to your respiratory system, virus cells can enter into nerve and receptor cells and cause damage. It can take a long time for these cells to repair and some cells may never fully recover from the virus.

17 Night Sweats

According to Kaiser Permanente, night sweats are different from regular sweating because they occur only at night and include intense sweating, enough to soak through your clothes and sheets. It's possible that night sweats are present due to a residual fever but they may also be caused by thyroid level issues, menopause, anxiety, or infections. New medication or other lingering symptoms, such as chills and muscle aches, may also contribute to long-lasting night sweats.

16 Sore Throat

While not all coronavirus sufferers experience a sore throat, it's one of the common symptoms the CDC lists for the virus. According to the CDC, viruses and infections cause sore throats, which may be why this is a lingering symptom for some coronavirus patients.

15  Diarrhea
While it's not the most common, diarrhea is listed by the CDC as a symptom of COVID-19. A study conducted by several researchers analyzed 206 patients with low severity COVID-19 and 48 experienced digestive problems first before other coronavirus symptoms. Diarrhea lasted an average of 14 days for COVID-19 patients in the study.

14 Heart Palpitations

Even after the fever, headache, and dry cough have disappeared, some patients who have "recovered" from COVID-19 may experience heart palpitations. A study published in JAMA Cardiology examined 100 recovered COVID-19 patients and found that 78 of them had "cardiac involvement" while 60% had ongoing myocardial inflammation. Ongoing heart issues, such as palpitations, may be long-lasting for COVID-19 patients, regardless of their illness severity. 

13 Joint Pain

Dr. Richard Deem from Cedars-Sinai explains that as your immune system attempts to fight off COVID-19 or any type of illness, white blood cells produce interleukins to help join the fight. While these interleukins are useful in fighting off the virus cells, they also cause muscle and joint pain. The immune response may still be heightened in these recovering patients, causing this joint pain to last.

12 Cough

A lingering cough can be a side effect of any type of cold, flu, or illness. According to a study conducted by the World Health Organization (WHO) on Chinese COVID-19 patients, 61.7% developed a dry cough. As a respiratory virus, the cough associated with COVID-19 may take a long time to go away because your body is attempting to get rid of lingering mucus and phlegm. 

11 Persistent Chest Pain or Pressure

Chest pain or pressure was a common lingering COVID-19 symptom among survey participants. Since coronavirus affects the lungs and respiratory system, this chest pain may be attributed to the virus still settling in the body. According to the Mayo Clinic, sudden, sharp chest pains are referred to as pleurisy and it may indicate that the lung walls are inflamed. Pleurisy may be a sign of pneumonia or another type of infection, so recovered COVID-19 patients should see a doctor if this symptom persists.

10 Dizziness

COVID-19 is a respiratory virus that also has nervous system side effects. According to a study published in the Journal of the American College of Emergency Physicians Open, "symptoms including headache, dizziness, vertigo, and paresthesia have been reported." This may be due to decreased oxygen levels, dehydration, fevers, or headaches also caused by the virus.

9 Memory Problems

A paper published in the Journal of Alzheimer's Disease analyzes potential long-term neurological effects of COVID-19 on patients who experienced severe cases. Memory problems and cognitive decline are potential side effects for some of these patients.  Since the virus affects the nervous system, memory problems may be a lingering side effect for some patients, especially those who suffered severe cases.

8 Anxiety

According to a poll conducted by the American Psychiatric Association, about 36% of Americans feel coronavirus has had a serious impact on their mental health. Between quarantining, social isolation, and worry about developing a severe case of coronavirus, it's no wonder anxiety is a lingering symptom for COVID-19 patients.


7 Difficulty Sleeping

Sleep is crucial because it keeps the immune system functioning properly, heightens brain function, stabilizes mood, and improves mental health. 782 survey respondents claimed they were having difficulty sleeping, even after recovering from COVID-19. This lack of sleep may be due to anxiety or worry about the virus or may be attributed to other lingering symptoms, such as muscle pain or cough. Setting specific bedtimes and only using your bed for sleep may help with these difficulties.

6 Headache

According to Dr. Sandhya Mehla with the Hartford HealthCare Headache Center, "It is estimated that headache is a symptom of COVID-19 in about 13% of patients with COVID-19. It is the fifth most common COVID-19 symptom after fever, cough, muscle aches, and trouble breathing."
In the survey, 902 participants claimed that a headache was a long-lasting symptom after COVID-19. This may be due to dehydration, congestion, or other symptoms of coronavirus, such as a fever.

5 Inability to Exercise or Be Active

After recovering from COVID-19, some patients find it hard to exercise or be active, even if they were fit before contracting the virus. 916 survey participants reported that they were still unable to exercise after recovering from coronavirus. According to a study published in JAMA Cardiology, researchers recommend that patients who suffered from severe cases of COVID-19 wait at least two weeks before resuming light exercise. This allows time for doctors to see if heart or lung conditions develop that could make it dangerous to engage in physical activity.

4 Difficulty Concentrating or Focusing

The long-term effects of COVID-19 are unknown since the virus is so new but researchers are seeing certain neurological effects on patients who have recovered. Studies conducted in Wuhan analyzed these neurological conditions and found that 40% of the patients analyzed experienced confusion and conscious disturbance. This is commonly referred to as "brain fog" and many patients express feeling this way while recovering from coronavirus. 

3 Shortness of Breath or Difficulty Breathing

According to John Hopkins Medicine, shortness of breath is when you feel like you can't get enough air or your chest is tight. Most people feel this way after exercising or if they're experiencing a panic attack. However, patients with COVID-19 may feel shortness of breath without even moving since it's a common symptom of the virus. In the survey, 924 COVID-19 patients claimed that shortness of breath or difficulty breathing was a long-lasting coronavirus symptom. 

2 Muscle or Body Aches

Body aches are a common symptom of many illnesses, including coronavirus. In this survey, 1,048 participants reported feeling these body aches after their COVID-19 diagnosis. According to Dr. Tania Elliott, MD FAAAAI, FACAAI, "Your body aches when you have the flu because your immune system is revving up to fight infection." It's not necessarily the virus that causes these aches but your body's own reaction to the virus invasion.

 
1 Fatigue


Fatigue was the most common lingering symptom of coronavirus. According to a study conducted by the WHO, the average recovery time for mild coronavirus cases is around two weeks but three to six weeks for severe or critical cases. Lingering fatigue may be a sign that your body is still fighting the virus or is recovering from the fight.
If you experience any of these conditions, it may or may not be COVID-19—contact a medical professional immediately. Stay healthy and keep others healthy, too: Wear your face mask, get tested if you think you have coronavirus, avoid crowds (and bars, and house parties), practice social distancing, only run essential errands, wash your hands regularly, disinfect frequently touched surfaces, and to get through this pandemic at your healthiest, don't miss these 35 Places You're Most Likely to Catch COVID.





































































































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11 Early Signs You've Caught COVID

20/10/2020

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Identifying COVID-19 symptoms has never been more important. According to the Centers for Disease Control and Prevention, there is a wide range of symptoms reported by those who have been infected with the virus. And, while the average incubation period is around 5-6 days, some people experience signs of the infection as soon as two days after exposure. Here are 11 early signs you should look out for, according to some of the nation's top medical experts. Read on to discover the warning signs so you can seek help when necessary, and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had Coronavirus.

You Have a Loss of TasteAccording to Amir Masoud, MBBS, a Yale Medicine gastroenterologist, one of the earliest symptoms of COVID-19 is loss of taste. Also called ageusia, this symptom can appear in as little as two days after exposure. And, according to "long haulers"—a term used to describe those who don't fully or immediately recover from the virus—the symptom can linger for months on end. 

You Have a Loss of Smell Along with loss of taste, Dr. Massoud says that those infected with the virus might experience a loss of smell, also called anosmia, early in the infection. "As the coronavirus infects the body, it invades your olfactory organ, which is responsible for your sense of smell, and damages the blood vessels feeding this organ," explains William W. Li, MD, internationally renowned physician, scientist and author of the New York Times bestseller Eat to Beat Disease: The New Science of How Your Body Can Heal Itself. As a result, you may not be able to smell normally.  "If you have this in conjunction with any of the other symptoms, it's best to let your doctor know right away," he suggests. 

You Have DiarrheaWhile less common than loss of taste or smell, gastrointestinal issues can be an early sign of coronavirus says Dr. Massoud. One of them is diarrhea. 

You Have NauseaThe second gastrointestinal symptom that can be an early sign of COVID is nausea, Dr. Massoud reveals. 

You Have FatigueAccording to a study published in JAMA, one of the most common early symptoms of the virus was fatigue, reported by over 68 percent of those surveyed. However, the feeling of being excessively tired is rarely independent of others, points out Dana Mincer, DO, Amwell Family Physician and Urgent Care Doctor. "Fatigue is usually paired with something else — a low grade fever to a high grade fever and body aches," she explains. 

You Have a Dry CoughA dry cough—"one that does not produce mucus," per Dr. Mincer—is another early sign of the virus. "The SARS-CoV-2 coronavirus that causes COVID-19 is a respiratory virus, so it's no surprise that the majority of people who are infected have a cough," Dr. Li adds. According to the survey, over 60 percent of those surveyed identified it as a symptom.

You Have a FeverWhile a fever can signify a variety of ailments, as it is a sign the body is fighting off an infection, over 55 percent of people surveyed claimed it was an early symptom of COVID. According to Dr. Mincer, coronavirus fevers can vary in temperature from low-grade—99.5 to 100.3—to high. And, like a fatigue, a coronavirus fever is usually paired with other symptoms. When should you be concerned? "Take your temperature and if it's 100.4˚F, you should monitor and if persistent, call your doctor to check in," Dr Li suggests. However, keep in mind that not everyone with COVID-19 develops a fever, and there are many other illnesses besides COVID that cause fever, especially during flu season.

You Have Muscle or Body AchesFeeling pain in your body could mean you are sick with COVID. According to the survey, nearly 45 percent reported muscle or body aches. Again, Dr. Mincer points out that this symptom is rarely independent if it is related to a COVID infection. 

You Have a HeadachePay attention to any headaches you experience. According to the survey, nearly one-third of coronavirus patients report a headache. 

You Have Shortness of BreathShortness of breath is one of the virus' defining symptoms. "About half of my patients experience respiratory symptoms that range from mild to severe," explains Mincer. This type of manifestation of the virus generally takes about 5 days post infection to arise, which she explains, is when more serious cases can be identified. "If you are going to have severe symptoms, day 5 is generally when they present," she maintains. According to a study published in The Lancet, most hospital admissions occur around day 7 or after. 

You Have a Sore ThroatAround a third of coronavirus patients report a sore throat. However, Dr. Mincer points out that some are more of a secondary symptom, "possibly as a result of the dry cough irritating their throat." She also explains that a coronavirus sore throat is different from other infections, including strep, as the throat will usually appear red and inflamed instead of visual white patches on the tonsils or red spots on the roof of the mouth. 

What to Do If You Have These SymptomsContact your medical professional immediately to discuss getting tested—and stay at home alone until you get word. 

Source: ETNT








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