2024-07-14 General/BC

COVID-19

Personal Recommendation

Y’know how I sung the praises of the Readimask a few weeks ago? I need to admit that I’ve had some trouble with a gap forming under my chin, especially in hot (i.e. sweaty) weather. I still like the Readimasks, and have fixed the problem for me with a piece of medical tape under the chin.

Later: This post shows a different method of sealing the mask on the face which I think is superior.

Long COVID

This preprint from USA (2024-07-07) reports that they have developed a blood test for (most) Long COVID!!! 🍾 They developed a sensitive blood test for pathogen antibodies, but which can distinguish between what virus is active right now as opposed to some time in the past. When they looked at Long COVID patients, they found SARS-CoV-2 in 40% of the samples, and none in the people who did not have Long COVID. Not only that, 60% of the Long COVID patients and none of the controls had active infections of at least one of four viruses: SARS-CoV-2, Epstein-Barr Virus, Cytomegalovirus, and/or Herpes Simplex 2 (AKA genital herpes).


This paper from USA (2024-05-05) suggests that metformin might be particularly good for women with Long COVID. They found that COVID-19 infections lead to higher levels of Reactive Oxidative Species (ROS) in women, which leads to hyperproliferation of T cells — which can be calmed down by metformin. (Men had normal levels of ROS but more lipid oxidative damage.) They did not actually test it in mice or humans, however.

This article gives a more detailed and somewhat less jargon-y explanation of the paper.


This paper from USA (2024-07-11) reports that a 9.3% of people who were pregnant during their first SARS-CoV-2 infection got Long COVID.


This paper from Iran from last year (2023-06-14) reports that antihistamines improve cognition in Long COVID patients. They found that patients given 40 mg twice daily of famotidine (an H2 agonist (see below under Treatments for an explanation of agonists)) for twelve weeks did significantly better on a battery of cognitive tests and a bit better on mental health tests than the placebo control group. (WARNING: the figures are not as stunning as they look — the y-axis origin is not set to zero.)

Comparison of Mini-Mental State Examination scores; warning non-zero y-axis
Comparison of Montreal Cognitive Assessment scores; warning: non-zero y axis
Comparison of Hamilton Depression Rating Scale scores; warning, non-zero y-axis
Comparison of Hamilton Anxiety Rating Scale scores; warning, non-zero y-axis

This paper from Italy from last year (2024-07-16) also reports that antihistamines help Long COVID patients. They gave patients an H1 histamine blocker (180 mg/day of fexofenadine) and an H2 blocker (40 mg/day of famotidine) for 20 days, and symptoms disappeared completely in 25% of patients!

I’m wondering why I haven’t heard more about antihistamines and Long COVID, given that these really promising results are a year old.


This paper from Sweden (2024-07-01) reports that a high proportion of people lost their sense of smell. Fifteen months after getting COVID-19, 51% of healthcare workers said they had lost their smell and 37% had a measurable loss of smell. Oddly, 20% of the COVID-free controls had a measurable loss of smell but only 5% of the COVID-free controls said they had lost their smell. (No, I don’t understand how you can not know you have a loss of smell.) 2.6 years after infection, 24% of all the patients still had a loss of smell.


This paper from China (2024-07-10) reports that a lot of older COVID-19 patients have had Long COVID for a long time. 19.1% of people over 60 who had COVID Classic infections (i.e. early in the pandemic) were cognitively 2.5 years later. Severe COVID-19 (which seems to be a code for “was hospitalized”) and hypertension increased the risk of cognitive impairment.

Transmission

This paper from USA (2024-06-28) reports that COVID-19 was almost certainly in the US before they thought, although at an extremely low level. They looked at stored blood from blood banks, and found antibodies against the SARS-CoV-2 nucleocapsid (which is not in the vaccines) in 0.07% of blood donations between December 13, 2019 and January 22, 2020.

Pathology

This paper from USA from FORTY-FOUR YEARS AGO reports that a “common cold” coronavirus caused neurological disorders in at least 13.6% of patients! They looked at patients who had two blood draws, and didn’t have OC43 (a “common cold” coronavirus) at the first one and did at the second one. They threw out anybody who had almost anything else wrong with them (like antibodies to Epstein-Barr Virus or cancer). With the 44 patients left, six people had one of four neurological symptoms during (not after!) the period between the two blood draws — meningitis, convulsions, vertigo, and/or polyradicultis.

This unrolled thread does some explanation of the paper.


This paper using worldwide data (2024-07-10) reports that migrants do worse with COVID-19 on almost all measures. They found that migrants are 84% more likely to get COVID-19, 23% more likely to go to the ICU, and 46% more likely to die.


This paper from Italy (2024-07-09) reports that children born during the lockdown (which was very strict in Italy!) had a 44% lower risk of wheezing (which I think means “asthma diagnosis”) than the historical cohort.

Mental Health

This paper from Canada (2024-07-08) reports that mental health in children got better and worse in the first three years of the pandemic compared to pre-pandemic. Mental health hospitalizations overall went down slightly; hospitalizations for other things rose and fell:

  • anxiety and self-harm – up slightly;
  • personality disorders – up by 21%;
  • eating disorders – up by 66% for females and up 46% for males;
  • mood disorders – down by 18%;
  • substance disorders – down by 17%;
  • other mental health hospitalizations – down by 22%.

This paper from Canada (2024-07-08) reports that the frequency of eating disorders in girls changed over the course of the pandemic. The excess hospitalizations were highest the one-year anniversary of the pandemic, ranging from 2.02x higher than pre-pandemic in BC to 2.44x higher in Ontario than pre-pandemic. They also found that an increase in stringency rates led to a rise in eating disorders. A 10% increase in stringency (as measured by the Bank of Canada stringency index) led to higher eating disorder hospitalizations rates ranging from +5% in Quebec and Ontario to +11% in BC.


This paper from USA (2024-07-08) reported that children from lower-income families lost less mental health during the pandemic than children from wealthier families did!

Treatments

This paper from China (2024-07-02) reports that antihistamines give some relief from COVID-19 in test tubes and mice with human immune systems. The histamine receptor H1 (HRH1) appears to be an secondary entry site (after ACE2) into human cells, so drugs that bind to HRH1 make it harder for the virus to get into the human cells. (It’s not clear to me if HRH1 receptors can open the cells by themselves, or if they are a cofactor for ACE2 entry, making entry easier.) HRH1-targeting drugs (AKA “H1 agonists”) include a lot of over-the-counter antihistamines, including clemastine, astemizole, azelastine, brompheniramine, azelastine, loratadine, and ebastine.

This paper found that nearly all of the H1 agonists inhibited SARS-CoV-2 PsV infection in test tubes:

IC50 is the half-maximal inhibitory concentration of the drug

They also gave acrivastine to transgenic mice with human immune systems, infected them six hours later with COVID Classic, and autopsied them five days later. The autopsies showed very few signs of disease.

Note that the H1 agonists had a protective effect, so maybe take a pill of Semprex-D a few hours before boarding an airplane! (NB: Antihistamines usually make you drowsy, so don’t drive on antihistamines. Someone I know says that nasal spray antihistamines have reduced side effects.)


This blog post (about this paper from Pfizer (2024-04-30)) reports that the next generation of nirmatrelvir — the active ingredient in Paxlovid — looks really good. Ibuzatrelvir, a reformulated version of nirmatrelvir, doesn’t need ritonavir to be administered with it. (Ritonavir is just there to inhibit an enzyme which would break down the nirmatrelvir.) Also, ritonavir is behind the nasty taste of Paxlovid; no ritonavir, no nasty taste. Win!

Ibuzatrelvir has been in a Phase 2/3 trial for a little over two years and is on the US FDA’s FastTrack program, so I am guessing it will hit the market in under two years. (NB: I don’t have any evidence that it will be more effective at knocking down COVID than Paxlovid, just more pleasant to take.)

Mitigation Measures

I wasn’t sure which category to put this under, but this paper using data from six countries (2024-07-09) reports that people who ate healthier did better with COVID-19. People who ate more vegetables, herbs/spices, and fermented foods/beverages got COVID-19 less often and recovered faster.


You might already know that dogs and cats can catch COVID-19. You might not have known that this site sells masks for dogs!

Testing

This preprint from China (2024-06-26) reports that COVID-19 alters the gene expression of the people it infects, and those different gene expressions can be used (with existing PCR/NAAT technology) to recognize COVID-19 infections more sensitively. This means that you could have a test that would be able to tell you if you had COVID-19 right away, instead of having to wait a few days.

SARS-CoV-2 messes with the expression of a lot of genes (see graphic below), way more than other viruses. However, they can distinguish COVID-19 from other pathogens by looking at just three genes — all mostly expressed by T-cells. (Knowing which genes are involved could potentially help find treatments, not just tests, yay!)

This unrolled thread explains the paper in more detail, which reproduces this graphic from the paper:

and gives annotated version of the same graphic:

BC Wastewater

Jeff’s wastewater spreadsheet makes it look pretty certain that cases are rising in Fraser Health.

Recommended Reading/Watching

This is an excellent video on Long COVID. It talks about why it seems like way fewer people have Long COVID than the research says, why it’s even hard to talk about it, bad adaptations that governments are making, and more.

Something that this post mentions (that the video doesn’t) is that Long COVID can cause damage in the part of the brain that is aware of disabilities!

(NB: She merges what I call “COVID-Related Excess Death and Sickness” in with Long COVID, but that’s okay — everybody and their brother has a different definition of Long COVID and it’s not at all clear if CREDS should be in with Long COVID or not. )

H5N1

This article reports that three more human cases in a Colorodo poultry farm have tested positive for bird flu, with FORTY-EIGHT tests still pending. The article on the same subject also reports that they have identified eight more infected dairy herds this week, which means that about a third of the Colorado herds have been infected.


This article says that five more infected herds have been found, bringing the total to 145 herds in eight states.