Category: COVID-19

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COVID-19 : Cortisol Levels on Admission Can Help Predict Severity of Infection

Patients with COVID-19 who have high levels of the steroid hormone cortisol on admission to hospital have a substantially increased risk of dying, UK researchers have discovered.

Waljit S. Dhillo, MBBS, PhD, head of the Division of Diabetes, Endocrinology and Metabolism at Imperial College London, UK, and colleagues studied 535 patients admitted to major London hospitals. Their article was published online June 18 in Lancet Diabetes & Endocrinology.

“Our analyses show for the first time that patients with COVID-19 mount a marked and appropriate acute cortisol stress response,” say Dhillo and colleagues.

Moreover, “high cortisol concentrations were associated with increased mortality and a reduced median survival, probably because this is a marker of the severity of illness.”

So measuring cortisol on admission is potentially “another simple marker to use alongside oxygen saturation levels to help us identify which patients need to be admitted immediately, and which may not,” Dhillo noted in a statement from his institution.

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Headache May Predict Clinical Evolution of COVID-19

Headache may be a key symptom of COVID-19 that predicts the disease’s clinical evolution in individual patients, new research suggests.

An observational study of more than 100 patients showed that headache onset could occur during the presymptomatic or symptomatic phase of COVID-19 and could resemble tension-type or migraine headache.

Headache itself was associated with a shorter symptomatic period, while headache and anosmia (loss of sense of smell) were associated with a shorter hospitalization period.

In a subgroup of participants, headache persisted even after the symptoms of COVID-19 had been resolved.

Investigators note that understanding the pathophysiology of headache in COVID-19 could improve understanding of migraine and other headache disorders.

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COVID-19 : 3 Stages to Brain Damage & Neurobiology of Disease

A new review outlines a three-stage classification of the impact of COVID-19 on the central nervous system and recommends hospitalized patients with the virus all undergo MRI to flag potential neurologic damage and inform postdischarge monitoring.

In stage 1, viral damage is limited to epithelial cells of the nose and mouth, and in stage 2 blood clots that form in the lungs may travel to the brain, leading to stroke. In stage 3, the virus crosses the blood–brain barrier and invades the brain.

“Our major take-home points are that patients with COVID-19 symptoms, such as shortness of breath, headache, or dizziness, may have neurological symptoms that, at the time of hospitalization, might not be noticed or prioritized, or whose neurological symptoms may become apparent only after they leave the hospital,” lead author Majid Fotuhi, MD, PhD, medical director of NeuroGrow Brain Fitness Center, McLean, Virginia, told Medscape Medical News.

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COVID-19 : Antibodies Can Disappear After 2-3 Months, Study Shows

People who develop antibodies after becoming infected with the coronavirus may not keep them more than a few months, especially if they showed no symptoms to begin with, a Chinese study shows.

Previous studies had found that most people who became infected developed antibodies. Health departments around the world give antibody tests as a way to prove a person has already had the coronavirus.

Scientists in the Wanzhou district of China studied 37 people who became infected with the coronavirus and showed symptoms and 37 people who became infected and showed no symptoms, according to the study published in the online journal Nature Medicine.

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COVID-19 : Prevalence of Asymptomatic SARS-CoV-2 Infection, A Narrative Review

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread rapidly throughout the world since the first cases of coronavirus disease 2019 (COVID-19) were observed in December 2019 in Wuhan, China. It has been suspected that infected persons who remain asymptomatic play a significant role in the ongoing pandemic, but their relative number and effect have been uncertain.

The authors sought to review and synthesize the available evidence on asymptomatic SARS-CoV-2 infection. Asymptomatic persons seem to account for approximately 40% to 45% of SARS-CoV-2 infections, and they can transmit the virus to others for an extended period, perhaps longer than 14 days.

Asymptomatic infection may be associated with subclinical lung abnormalities, as detected by computed tomography. Because of the high risk for silent spread by asymptomatic persons, it is imperative that testing programs include those without symptoms. To supplement conventional diagnostic testing, which is constrained by capacity, cost, and its one-off nature, innovative tactics for public health surveillance, such as crowdsourcing digital wearable data and monitoring sewage sludge, might be helpful.

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