CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 03/01/2021

WHO MIGHT HAVE COVID VACCINE IN TEXAS?

Texas COVID-19 Vaccine Availability

HELLO: THIS MAILOUT CONTAINS LONG COVID ARTICLES. THERE ARE SEVERAL READERS WITH A SPECIAL INTEREST IN LONG HAUL. I’LL START KEEPING ANOTHER BATCH AS WELL. 

MENTAL HEALTH OF SURVIVORS Several recent articles have investigated mental health effects of the COVID-19 pandemic. One study conducted by researchers in Italy, published in JAMA: Psychiatry, evaluated post-traumatic stress disorder (PTSD) in survivors of severe COVID-19 disease. The study involved 381 patients who sought care through an emergency department. Trained psychiatrists diagnosed PTSD in these patients using a standardized Clinician-Administered PTSD Scale, based on the results of a psychiatric assessment. The researchers diagnosed PTSD in 115 (30%) of the participants as well as depressive episodes in 66 (17%) and generalized anxiety disorder in 27 (7%). The presence of persistent medical symptoms was among the factors significantly associated with PTSD diagnosis. While a relatively small sample size, this study provides evidence that severe COVID-19 disease could be associated with longer-term mental health issues in recovered patients. This illustrates the broad array of long-term health conditions that can stem from COVID-19. 

LONG HAUL COVID DISCUSSION: (CITED BY HOPKINS)

LONG COVID As more and more people recover from acute COVID-19 disease, clinicians and researchers are gathering additional information on the chronic effects of SARS-CoV-2, commonly referred to as “long COVID.” A study conducted in Israel, published in Clinical Microbiology and Infection, investigated chronic symptoms in recovered COVID-19 patients over a 6-month period. The study included 103 patients who recovered from mild COVID-19 illness, and investigators collected data on the onset and duration of a variety of symptoms. Fever was among the first symptoms to resolve, with a mean duration of 5.6 days, whereas fatigue (31.1 days), difficulty breathing (18.6), and changes to taste (18.6) and smell (23.5) tended to persist longer. Notably, nearly half of the participants reported chronic symptoms that persisted for 6 months, including 22% with ongoing fatigue, 15% with changes to taste and smell, and 8% with breathing difficulties. The onset of some of the chronic symptoms—such as fatigue, breathing difficulties, memory disorders, and hair loss—tended to be reported after the 6-week point, indicating that they were newly developed conditions in recovered patients rather than longer-term continuations of acute disease………Increasing prevalence of long-term health effects from SARS-CoV-2 infection are raising concerns regarding how long-term care will be managed for patients with long COVID. Chronic health conditions such as fatigue, neurological disorders, and difficulty breathing can be debilitating for some patients, and advocates and elected officials have raised the possibility of classifying long COVID as a disability. Patients with severe chronic conditions following SARS-CoV-2 infection may be unable to return to work, or school or other activities, but they may not be eligible for Social Security Disability Insurance benefits. Some advocates have called on the US Social Security Administration to proactively issue guidance regarding how to handle COVID-19-related claims, in anticipation of increased need in the coming months and years for disability support for recovered patients, including financial support or accommodations or assistance in the workplace.

CITED BY HOPKINS:

New Policy Brief Calls on decision-makers to support patients as 1 in 10 report symptoms of “long COVID” (WHO) Some 1 in 10 people still experience persistent ill health 12 weeks after having COVID-19, termed “long COVID” or post-COVID conditions. A new policy brief from the European Observatory on Health Systems and Policies documents responses to post-COVID conditions in different countries of the WHO European Region and looks at how sufferers, including medical professionals, are driving some of those responses. Written for decision-makers, this brief summarizes what is known about the conditions, who and how many people suffer from them, diagnosis and treatment, and how countries are addressing the issue.

SAVED LONG HAUL ARTICLES IN MY FILES:

LONG HAUL ARTICLES, USUALLY NEWEST ON TOP

BEST ARTICLE I HAVE WITH NOTATIONS FORM EARLIER INFECTIONS

The lasting misery of coronavirus long-haulers

14 SEPTEMBER 2020 (good article)

“…Evidence from people infected with other coronaviruses suggests that the damage will linger for some. A study3 published in February recorded long-term lung harm from SARS, which is caused by SARS-CoV-1. Between 2003 and 2018, Peixun Zhang at Peking University People’s Hospital in Beijing and his colleagues tracked the health of 71 people who had been hospitalized with SARS. Even after 15 years, 4.6% still had visible lesions on their lungs, and 38% had reduced diffusion capacity, meaning that their lungs were poor at transferring oxygen into the blood and removing carbon dioxide from it.

Some people who have recovered from COVID-19 could be left with a weakened immune system…. SARS, for instance, is known to decrease immune-system activity by reducing the production of signalling molecules called interferons4.

Su and her colleagues hope to enrol thousands of people worldwide in a project called the COVID Human Genetic Effort, which aims to find genetic variants that compromise people’s immune systems and make them more vulnerable to the virus… The virus can also have the opposite effect, causing parts of the immune system to become overactive and trigger harmful inflammation throughout the body….

Heart of the matter

An over-reactive immune system can lead to inflammation, and one particularly susceptible organ is the heart. During the acute phase of COVID-19, about one-third of patients show cardiovascular symptoms, says Mao Chen, a cardiologist at Sichuan University in Chengdu, China. “It’s absolutely one of the short-term consequences.”

Studies are now starting. At the beginning of June, the British Heart Foundation in London announced six research programmes, one of which will follow hospitalized patients for six months, tracking damage to their hearts and other organs….

Chertow says he is not aware of such a study for COVID-19, but they have been done for other diseases. Following the Ebola epidemic in West Africa in 2014–16, US researchers collaborated with the Ministry of Health in Liberia to perform a long-term follow-up study9 called Prevail III. The study identified six long-term impacts from Ebola, ranging from joint pain to memory loss. Bhadelia, who treated hundreds of people with Ebola during the outbreak, says that these post-viral symptoms had not previously been recognized. Usually, she says, “we don’t stick around past the acute stage. We don’t look at the long tail of recovery. It’s important to do that, because it tells you more about the virus and its pathophysiology.”

The situation is clearer for people who have been severely ill with COVID-19, especially those who ended up on ventilators, says Chertow. In the worst cases, patients experience injury to muscles or the nerves that supply them, and often face “a really long-fought battle on the order of months or up to years” to regain their previous health and fitness, he says. He and his colleagues are now recruiting people with COVID-19 from across the severity spectrum for a long-term follow-up study, assessing their brains, lungs, hearts, kidneys and inflammation responses while they are acutely ill, then during recovery a few weeks later, and again after 6–12 months (see go.nature.com/3mfqqxc).

Once again, there is evidence from SARS that coronavirus infection can cause long-term fatigue. In 2011, Harvey Moldofsky and John Patcai at the University of Toronto in Canada described 22 people with SARS, all of whom remained unable to work 13–36 months after infection10. Compared with matched controls, they had persistent fatigue, muscle pain, depression and disrupted sleep. Another study11, published in 2009, tracked people with SARS for 4 years and found that 40% had chronic fatigue. Many were unemployed and had experienced social stigmatization.

It is not clear how viruses might do this damage, but a 2017 review12 of the literature on chronic fatigue syndrome found that many patients have persistent low-level inflammation, possibly triggered by infection. (LONG TERM STUDIES ARE BEING DONE NOW)

LONG HAUL IN NEUROLOGY, AUG, SEPT

? CAUSES: These patients, some of whom are physicians themselves are concerned that they could be stigmatized as being “functional.” Many of these symptoms overlap with those of patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).6,7 However one needs to be careful not jump to the conclusion that they have ME/CFS unless other possible causes of their symptoms have been investigated (table 2)….

  6. GENETIC CAUSE(S)–SEE FOLLOWING ARTICLE

HUMAN GENETICS

They found at least 3.5% of study patients with severe COVID-19, the disease caused by the novel coronavirus, have mutations in genes involved in antiviral defense.

And at least 10% of patients with severe disease create “auto-antibodies” that attack the immune system, instead of fighting the virus.

The results identify some root causes of life-threatening COVID-19…. They found at least 3.5% of study patients with severe COVID-19, the disease caused by the novel coronavirus, have mutations in genes involved in antiviral defense.

And at least 10% of patients with severe disease create “auto-antibodies” that attack the immune system, instead of fighting the virus.

The results identify some root causes of life-threatening COVID-19.

LONG COVID

LONG COVID The UK’s Office of National Statistics (ONS) published data regarding the prevalence of symptoms associated with “long COVID” in patients who recovered from acute SARS-CoV-2 infection. The data indicate that approximately 20% of infected individuals exhibit symptoms for 5 weeks or longer, and 10% report symptoms for 12 weeks or longer. This corresponds to an estimated 186,000 individuals in England with symptoms lasting between 5 and 12 weeks. The findings are based on responses to the UK’s COVID-19 Infection Survey, which utilizes a nationally representative sample from across the UK, and efforts are ongoing to gather additional data, including on symptoms that persist longer than 12 weeks. A more detailed look at the available data shows that prevalence of long COVID symptoms* tends to increase with age, peaking in the 35-49 years (26.8%) and 50-69 years (26.1%) age groups, compared to the 2-11 years (12.9%) and 12-16 years (14.5%) age groups. Additionally, there appears to be a statistically significant increase in prevalence among women (23.6%) compared to men (20.7%).

THE NEXT ARTICLES ARE CURRENT BUT NOT MUCH QUALITY, NAMES SOME REHAB PROGRAMS. ONE MENTIONS POST POLIO SYNDROME WHICH I HAVE SEEN MANY YEARS 

:

The Terrifying Long COVID Symptom Doctors Are Now Warning About

Denied treatment, some Covid long-haulers could become lifelong-haulers By SHAYNA SKARFJANUARY 28, 2021

Long-haulers without positive test results are also being denied experimental drugs that are just starting to become available… Maimonides Medical Center’s Post-Covid Care Center.. Mount Sinai’s Center for Post-Covid Care…People without the resources that we have should not be abandoned to suffer “living death” because the U.S.’s Covid-19 testing system failed them early in the pandemic.

Explanations for ‘long Covid’ remain elusive. For now, believing patients and treating symptoms is the best doctors can do

This much is known: Long haulers, recovering patients whose symptoms persist after their coronavirus infections disappear, are a mix of younger people who never needed hospital care and older people with chronic conditions that predate Covid. Their symptoms trail the infection’s path through their lungs, hearts, muscles, nerves, and brains. Deadening fatigue can dog them for weeks or months. Sometimes their problems wane, then resurface in a stuttering pattern that leaves them wondering if they’ll ever get over the malaise.

“I don’t think this is going to be easy to figure out,” said Steven Deeks, a professor of medicine at the University of California, San Francisco, who is leading a clinical trial to find answers. “The vaccines and therapeutics, they were easy. With this post-acute Covid syndrome, we have no idea how to measure it. We have no prior experience in terms of defining it or treating it, so it’s kind of a wild, wild West right now.”

A survey conducted in the U.K. concluded in November that 1 in 5 people who tested positive for SARS-CoV-2 (the virus that causes Covid-19) suffered from symptoms lasting five weeks or longer; 1 in 10 said their problems lasted 12 weeks or longer. 

Post-viral infection is not new. It’s been seen with Ebola, and the first SARS virus in the early 2000s also gave rise to long-lasting symptoms after some people recovered. A 2009 study in Hong Kong found that psychiatric problems and chronic fatigue still plagued SARS-1 survivors up to four years later. People who completely recover from an Ebola infection can still suffer from fatigue, headaches, muscle, joint and stomach pain, eye problems, memory and hearing loss, and mental health issues. The Ebola virus can persist in their bodies, including in the eyes and the central nervous system, even after being cleared from the rest of the body.

Post-viral infection is not new. It’s been seen with Ebola, and the first SARS virus in the early 2000s also gave rise to long-lasting symptoms after some people recovered. A 2009 study in Hong Kong found that psychiatric problems and chronic fatigue still plagued SARS-1 survivors up to four years later. People who completely recover from an Ebola infection can still suffer from fatigue, headaches, muscle, joint and stomach pain, eye problems, memory and hearing loss, and mental health issues. The Ebola virus can persist in their bodies, including in the eyes and the central nervous system, even after being cleared from the rest of the body.

“Meeting patients where they are at and believing them is the most important thing we do, telling them ‘I hear you, I believe you, and I’m going to try to help you navigate the health care system and figure this out,’” said Dr. Monica Lypson, co-director of the COVID-19 Recovery Clinic at George Washington University Medical Faculty Associates in Washington, D.C. 

Long-haul COVID-19 similar to post-polio syndrome

….long-haul COVID-19 refers to the ongoing adverse health effects of coronavirus infection, which can last for weeks, and even months, after the initial phase of their illness has passed. Symptoms include persistent fatigue or exhaustion; ongoing shortness of breath; heart arrhythmias, including a racing heartbeat; pain in the muscles and joints; and headache. Many patients report difficulties with concentration and memory, which they refer to as “brain fog.” Some experience uneven recoveries in which they appear to be on the mend but relapse into illness again.

Post-polio syndrome, by contrast, arises years later, usually a decade or more after the initial illness. The condition makes itself known with a gradual weakening of the body as a whole, and of the specific muscles and muscle groups that had been previously affected by the polio infection. In some cases, the muscles may also begin to atrophy, or decrease in size. Physical changes to the joints may also take place. Some people experience trouble with breathing, become sensitive to hot or cold temperatures, and may develop sleeping disorders.

Both long-haul COVID-19 and post-polio syndrome occur only in a subset of survivors. There are believed to be about 300,000 polio survivors in the U.S., and from one-fourth to one-half of them may experience some degree of post-polio syndrome. Long-haul COVID-19 is so new that we don’t yet know how often it occurs, but it may be as many as 20% of patients with COVID-19. People with either syndrome may experience only mild symptoms, or they can find themselves dealing with what is essentially a new and ongoing illness.

As for why these viruses continue to affect people after the initial infection has passed, the answers are not yet clear. When it comes to post-polio syndrome, one theory suggests that the patient’s recovery from the initial paralysis involved the regrowth of new nerve pathways, which then become overtaxed as the years pass. Newer thinking suggests that the polio virus may go dormant within the body, and then, for reasons that are not yet understood, reactivate years later.

With long-haul COVID-19, new research from scientists at the University of California, Davis, suggests that the ongoing respiratory and cardiac effects arise from lung damage sustained during the initial illness. In relapsing cases of COVID-19, it has been theorized the immune system is continuing to encounter fragments of the virus and mounting a defense that results in another round of symptoms. The hope is that, as research continues, effective treatments for long-haul COVID-19 will be found.

• Dr. Eve Glazier is an internist and associate professor of medicine at UCLA Health. Dr. Elizabeth Ko is an internist and assistant professor of medicine at UCLA Health. Send your questions to askthedoctors@mednet.ucla.edu.

COVID long-haul patients seek answers months after contracting COVID-19

Internal vibrations are a recognized symptom in neurological diseases such as Parkinson’s disease and multiple sclerosis.

England has opened or plans to open at least 81 post-COVID clinics to treat people with lingering symptoms or new symptoms that arise after COVID-19.

Two post-COVID clinics are now operating in Calgary at the Peter Lougheed and Rockyview hospitals.

Patients wishing to attend the clinic will need a referral, and must be at least 12 weeks out from their positive COVID-19 diagnosis. Weatherald said it’s not unusual to see breathing problems eight weeks out, but by three months the vast majority of cases have been resolved.

He recognized that the positive test requirement does close the door to people who may have contracted COVID-19 in the earliest days of the pandemic.

Many Albertans were unable to get a PCR test in the first months of the lockdown, as the province initially limited those tests to certain people such as travellers and their known close contacts.

Long-haul COVID cases shed new light on chronic fatigue sufferers

“If I have one message for doctors, it’s ‘believe your patients.’”

(good general article and current, one rx with ….. Rowe knew from interviews with the boy’s mother that he had an extraordinary appetite for salt. So much so that he kept a shaker at his bedside and would regularly sprinkle salt on his hand and lick it off.

Rowe hypothesized that he was dealing with a sodium retention problem. To counter it, he prescribed the steroid fludrocortisone, which promotes sodium resorption in the kidneys. Three weeks later, the boy had recovered so dramatically he was helping a neighbor with a landscaping project, pushing rocks around in a wheelbarrow. “He was a different kid,” Rowe said.

(good current chatty article)

GOOD ARTICLES AND REFERENCES AND CHARTS FROM “VERY WELL HEALTH” WWW.verywellhealth.com

https://www.verywellhealth.com/fibromyalgia-symptoms-716139

https://www.verywellhealth.com/fibromyalgia-covid-19-5079661

**********

The World Health Organization has announced that dogs cannot contract Covid-19. Dogs previously held in quarantine can now be released.  To be clear, WHO let the dogs out?

Relationships are a lot like algebra. Have you ever looked at your X and wondered Y?

***********************************

GIVE US YOUR FEEDBACK.  CLICK ON “COMMENT” TO TELL US WHAT YOU THINK or use one of the alternative methods for providing feedback.

Click here to submit feedback.  Let us know what you think.

click here to CLOSE THIS PAGE

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s