2024-03-29 General – Pandemic in British Columbia

Treatments

This article from USA (2024-03-25) says that the FDA has approved Pemgarda, a monocolonal antibody, for use as a pre-exposure preventative for immunocompromised people. It will be used sort of like a vaccine. (Evusheld used to be effective for that, but SARS-CoV-2 mutated enough that Evusheld stopped being effective.) This is big news for immunocompromised people! (I have no information on where Pemgarda is in Health Canada’s pipeline.)

This paper from Hong Kong (2024-03-20) found that Paxlovid was more effective (61% for ages 60-79, 66% for over 80 y/o) than Molnupiravir (35% for ages 60-79, 42% for over 80 y/o) at preventing COVID-19 deaths.

COVID-Related Excess Sickness and Death

This preprint from USA (2024-03-07) found that people who had mild to moderate COVID-19 had brain age gaps (i.e. brain age as measured by MRIs minus actual age) that were 2.65 years bigger than non-COVID controls. Having a higher brain age gap correlated with a lower cognitive score.

When they looked at the proportion of people who had brain age gaps, 91% of post-COVID men had a brain age gap, while only 64% of the post-COVID women did.

This preprint using data from USA (2024-03) found that excess cancer deaths rose 1.7% in 2020, 5.6% in 2021, and 7.9% in 2022.

This paper from USA (2024-03-20) found that people who had COVID-19 infections were about 39% more likely to have neurological complications later on than people who had influenza infections.

I don’t think this means we should relax about COVID-19, I think it means we should pay more attention to influenza! Influenza is not mild!

<soapbox>People say “the flu” a lot for what was probably a cold. (A doctor once told me, “if you don’t feel like you got hit by a bus, it wasn’t influenza”.) When people say, “oh, COVID is just like the flu”, they are underselling how bad the flu is. Because people tend to conflate colds and flus, what those people were really saying is “oh, COVID is just like a cold” which it isn’t.<end soapbox>

Long COVID

This paper from UK (2024-03-19) found that people with generalised joint hypermobility were 33% more likely to get Long COVID, and more likely to have fatigue, than controls, even after adjusting for lots of covariates.

Interestingly, in a previous study (2021-01-21) of ME/CFS patients, the same authors had found that 81% of ME/CFS patients that they studied had joint hypermobility.

There was a paper recently which said that Long COVID patients had elevated proteins from the complement system. This preprint from Germany (2024-03-18) says that if you control for other variables, that correlation goes away.

This paper from Sweden (2024-03-26) found that your risk of Long COVID rises with the severity of your acute COVID bout. People who had mechanical ventilation during their acute COVID phase were 114 times more likely to get Long COVID than unhospitalized patients.

Pathology

In this paper from China (2024-02-29), 64.19% of patients hospitalized with Omicron had sepsis. Patients who had sepsis, unsurprisingly, went to the ICU more often and died more often than those without sepsis.

This paper from China (2024-03-05) found when retrieving eggs (as part of IVF) from women with COVID-19 infections, there were fewer eggs and they were lower quality than those from controls.

The paper said, “From SARS-CoV-2 infection until oocyte retrieval, it took an average of 6.63 days”, which makes it sound like the women were actively infected at the time of retrieval, which seems a little odd, but maybe the only time the IVF clinic knew they’d had COVID-19 (so they could include them in the study) was if they had COVID-19 right at the time when they were at the clinic.

This study also found SARS-CoV-2 in the follicular fluid (found in the little bubble around the egg). This means that you can now add ovaries to the list of organs where SARS-CoV-2 has been found.

This paper from Italy (2024-03-18) found that patients who had had asymptomatic to mild COVID-19 between January 2022 and May 2023 had higher levels than healthy controls of two proteins (neurofilament light chain and glial fibrillary acidic) which are markers for certain kinds of damage in the brain. Patients with cognitive impairment had even higher levels. Ten months later, their levels of the markers were lower, but still higher than healthy controls. (I don’t know if the marker levels going down means that the brain had healed or if it just wasn’t getting damaged any more.)

Transmission

This paper (2024-03-15) found that the lower the humidity, the faster water droplets evaporate and the higher the concentration of hydrogen peroxide (a disinfectant!) in the droplets is. Apparently if the water in the droplet evaporates completely, that leaves a dried-out virus particle just happily floating along, and it can drift for a long time. 😬

This case study (2024-03-21) examined a bus driver in Germany who didn’t bother to quarantine when he was supposed to. Kids who rode the bus (~20 min ride) were four times as likely to get COVID-19 as kids who did not.

This case study (2024-03-04) covered an 7-story apartment building in Northern Ontario built in the 1970s which had a cluster of genomically identical COVID-19 cases in February 2021. They found that the HVAC system had some uncontrolled air leakage between units.

Mitigation Measures

I have read studies like this one from USA (2024-03-20) that Far-UV was a good way to disinfect air, but it’s a pain to install Far-UV lamps in one’s house, and I personally have enough control of my house that I don’t feel the need to disinfect it. (If other people in your household are a threat, I could see that you might want to disinfect your home.) HOWEVER. I just discovered this company makes Far-UV flashlights. (<- That page also has links to a lot of Far-UV information resources.) That seems like a good idea for travelling.

Vaccines

This Moderna press release (2024-03-26) says that their new vaccine (mRNA-1283) is more effective than their current offering (mRNA-1273.222), especially for people over 65.

In this Moderna press release from the next day (2024-03-27), they mentioned that mRNA-1283 is refrigerator-stable and will come in pre-filled syringes, which should give it much simpler distribution logistics!

Being press releases, they are really short on details like how the new vax is different from the old vax, exactly how much better it is, etc., alas. I will keep my eye out for more information.

This paper from USA (2024-03-19) found that people who got a bivalent booster were no more likely to have strokes than those who did not. However, there was an increased risk (+~20%) of stroke for people who got a COVID-19 booster and a flu shot close in time.

This report from USA (2024-03-28) found that XBB.1.5 booster doses were 38% effective (declining to 34% effective after 60 days) against hospitalization in immunocompromised adults compared to unvaccinated immunocompromised adults.