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Back with a vengeance used to mean getting sick-pulled right before a night out. Here’s what’s new as Covid re-spikes in the US.
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Hotspots are still vulnerable
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Spain got hit hard, but like a lot of Covid hotspots, most of the population remains unexposed. A study of 60,000 Spanish residents from across the country found an estimated nationwide seroprevalence of 5%. Urban areas including Madrid peaked at a seroprevalence of over 10%. This jives with data from Wuhan, the origin of the outbreak, taken about 2 months after the peak of infection that pegs prevalence at roughly 4% of the population. Large scale herd immunity is nowhere in sight.
Lancet
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Multiple studies have now associated blood type A with increased susceptibility to severe Covid infection. The latest, a genomewide association study of Covid respiratory failure, looked for genetic variants linked to severe disease in 2,000 European participants. A strong signal emerged near genes that code for ABO blood type. The authors found that blood type A was associated with a 45% increased risk of Covid respiratory failure, while blood type O was associated with a 35% decreased risk. Be warned: no one really understands this, and correlation is definitely not causation here.
NEJM
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Trustworthy? Who knows. But it sounds good
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A study of 400 healthcare professionals in Wuhan who used appropriate personal protective equipment during encounters with infected patients found that none of the participants reported Covid-19 symptoms and none developed Covid antibodies. The goods employed in the study: protective suits, masks, gloves, goggles, face shields, and gowns. All of the participants were involved in risky aerosolizing procedures.
BMJ
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It has a name – COVID multisystem inflammatory syndrome – and now a case history from the New York State Department of Health. About 100 children under the age of 21 presented with symptoms found in Kawasaki's disease, toxic shock syndrome, and myocarditis in the setting of acute or recent SARS-CoV-2 infection. The overwhelming majority had fevers, chills, tachycardia, and GI symptoms, and inflammatory markers were sky-high. Two patients died, most were admitted to the ICU, and about half had evidence of myocarditis. Yet another reason to flatten the curve.
NEJM
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When you just can't do the cafeteria salad bar anymore
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Once a day can be tough. Results from HPTN 083 found that the bi-monthly injectable cabotegravir was superior to daily Truvada (oral tenofovir / emtricitabine) as pre-exposure prohylaxis (PrEP) for HIV prevention in 4,600 cisgender men who have sex with men and transgender women who have sex with men. The trial was stopped early after the HIV infection rate for cabotegravir, given every 8 weeks, was found to be one-third the rate found for Truvada. Cabotegravir now awaits FDA approval.
HPTN
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When a little is too much
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Using data from the Jackson Heart Study, researchers linked self-reported discrimination to incident hypertension in 1,800 African Americans without baseline hypertension. Over a max of 13-year follow-up, those who reported medium and high levels of lifetime discrimination were more likely to develop hypertension than those who reported low levels of lifetime discrimination after controlling for other factors.
Hypertension
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Send your interns something to look forward to
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