News scan for October 1, 2020

Loss of taste or smell accurately predicts COVID-19, according to a study

One study shows that four out of five people with recent loss of smell and / or taste tested positive for COVID-19 antibodies, and 39.8% of these had no cough or fever.

COVID-19 is known to cause a loss of taste and / or smell, but the SARS-CoV-2 antibody status of people who experienced these symptoms was previously unknown. A PLOS Medicine the study today sought to explore the significance of loss of taste / smell as a predictor of COVID status.

Researchers enrolled 590 people during the peak of the COVID-19 outbreak in London who self-reported a loss of taste / smell via telemedicine consultation in the previous month. Of participants with loss of smell and / or taste, 76.6% were HIV positive (carried antibodies to SARS-CoV-2), with participants experiencing loss of smell alone nearly three times more likely to be HIV positive compared to participants who experienced loss of taste alone (odds ratio 2.86; 95% confidence interval, 1.27 to 6.36; P. <0.001), suggesting that loss of smell is a highly specific symptom of COVID-19.

The authors conclude: “In a community-based population, the vast majority of participants with new-onset loss of smell were seropositive for SARS-CoV-2 antibodies. Acute loss of smell should be considered globally as a criterion for isolation, testing and contact tracing to contain the spread of COVID-19. “

Significantly, 39.8% of COVID-19 positive participants had neither cough nor fever. Over-reliance on cough and fever as primary symptoms of COVID-19 can be misleading, and researchers support urgent recognition of loss of smell as a key symptom of COVID-19. The authors wrote: “Counterintuitively, people with minor symptoms, such as isolated loss of smell, who remain systematically well pose the greatest threat to public health.”

“Our results suggest that people who notice a loss in their ability to smell household odors such as garlic, coffee and perfumes every day should self-isolate and look for PCR. [polymerase chain reaction] test, “senior author Rachel Batterham, PhD, MSc, of University College London said in a PLOS press release.” Loss of smell must be recognized globally by policy makers as a key symptom of COVID-19. “
1st October PLOS Med
she studies
Press release PLOS 1st October

Higher risk of death from COVID-19 found in psychiatric patients

In the first known study of COVID-19 psychiatric patients and mortality, a JAMA Network Open yesterday’s study showed that patients with diagnosed psychiatric disorders have a significantly higher risk of death.

The 1,685-patient cohort study of the Yale New Haven Health System, a system of five hospitals in the northeast, studied patient mortality data from February 15 to May 27 using a Kaplan-Meier statistical analysis to compare survival rates. The study identified 473 patients (28%) previously diagnosed as having psychiatric disorders.

The overall mortality rate for all patients was 18.9%, with 318 hospital deaths. COVID-19 positive patients with psychiatric diagnoses had a significantly higher risk of hospital death, with a 4-week mortality rate of 44.8%, compared with 31.5% for non-psychiatric patients.

Patients with psychiatric diagnoses tended to be older, female, white, non-Hispanic, with other medical comorbidities. After adjusting for demographics, comorbidities, and hospital location, psychiatric patients had a 1.5-fold increased risk of death (hazard ratio, 1.5; 95% confidence interval, 1.1- 1.9; P. = 0.003).

“The finding is similar to previous findings: Individuals with concurrent psychiatric and medical diagnoses had worse outcomes and higher mortality,” the study authors wrote.

The authors noted that psychiatric disorders are associated with an overall shortened life expectancy of up to 10 years, but it is unclear why psychiatric illness predisposes patients to COVID-19-related mortality. There may be an association of psychiatric disorders with inflammatory processes, immune function, or an increased risk from psychotropic drugs, the authors suggest.
September 30th JAMA Netw Open she studies

Three other fatal cases of Ebola reported during the DRC outbreak; 128 cases, 53 fatal

Three probable retrospective Ebola deaths since July have added to the total in the Equateur province of the Democratic Republic of Congo (DRC), the United Nations Office for the Coordination of Human Affairs (UN OCHA) said today in a statement.

The development brings the total of the epidemic to 128 cases and 53 deaths. The three additional probable cases are all in the Bolomba health area, including one in the Boyenge health area, which had not previously reported any confirmed or probable cases. UN OCHA also said intervention teams and medical supplies have arrived in the Lusengo health zone, the most recent area hit by the outbreak.

The outbreak in Equateur province was first detected in June in the same area where an Ebola outbreak in 2018 sickened 54 people, 33 of them fatally.
1 October ONE OCHA relationship

The HPV vaccine has been shown to help prevent cervical cancer

While human papillomavirus (HPV) vaccinations have been linked to lower cervical cancer rates for years, researchers at the Karolinska Institutet in Solna, Sweden say their study is the first population study to look at more than just pre-cancer indicators but also the actual invasive cervical cancer.

The results, published today on New England Journal of Medicine, suggest a rate of 47 cervical cancer cases per 100,000 vaccinated women versus 94 cases per 100,000 in unvaccinated women, with an overall risk reduction of 63% -88% in those vaccinated earlier in life.

From 2006 to 2017, researchers followed nearly 1.7 million Swedish girls and women between the ages of 10 and 30, of whom more than 500,000 were vaccinated against HPV. After adjusting for all covariates such as age, residential area, follow-up time, and parental factors, including income and disease history, the study found that the incidence rate ratio was 0.12 in women who had been vaccinated before age 17 and 0.47 in those who had been vaccinated between 17 and 30 years.

The overall incidence rate ratio was 0.37, which translates to a 63% lower risk of cervical cancer, but among those who were vaccinated before age 17, the above incidence rate ratio results in a 88% lower risk of cervical cancer.

“Girls vaccinated at a young age appear to be more protected, probably because they are less likely to have been exposed to HPV infection and because HPV vaccination has no therapeutic effect against a pre-existing infection,” senior author Pär Sparén , PhD, said in a press release from Karolinska.
1st October N Engl J Med she studies

September 30 Press release of the Karolinska Institutet

WHO raises the alarm about the monkeypox epidemic in the DRC

The World Health Organization (WHO) today detailed an outbreak of monkeypox in the DRC, with 4,594 suspected cases reported so far this year, 171 of them fatal, with diseases spreading to 17 of the country’s 26 provinces.

Monkeypox is endemic in the DRC, but the number reported so far this year has already surpassed the country’s totals for this time of year for 2019 and 2018. Tests confirmed monkeypox in 39 of the 80 samples. sent to the laboratory of the Institut National de Recherche Biomédicale (INRB).

The most affected provinces include Sankuru, Mai-Ndombe and Equateur, with the latter province also battling the Ebola outbreak and the whole country struggling with the COVID-19 pandemic. WHO said one of the areas it is most concerned about is the Inongo health district in Mai-Ndombe province, where a quarter of the territory is affected.

More than half (58%) of suspected cases involve people over the age of 5, but the death rate for children under the age of 5 is 4.2%, compared to 3.4% in the age group higher.

WHO has warned that many provinces are juggling other disease epidemics with extensive financial resources, along with armed conflict and violence. And it notes that proximity to forests puts many residents, including hunters, in contact with the animals’ reservoirs. He said he’s gathering more information about the lab’s cases and capacity, and that support from partners like the U.S. Centers for Disease Control and Prevention (CDC) is critical.
1 October WHO declaration

Vietnam detects more H5N1 and H5N6 avian influenza in poultry

Vietnam reported multiple highly pathogenic avian influenza outbreaks in poultry today, one from H5N1 and three from H5N6, according to the latest notifications from the World Organization for Animal Health (OIE).

The H5N1 outbreak affected birds from villages in the province of Ca Mau, in the far south of the country. It started on September 3 and killed 63 out of 243 birds. The source of the virus is unknown and culling and vaccination were among the response steps. Vietnam reported its latest H5N1 outbreak on September 11 in birds from villages in Tra Vinh province, also in the south.

Meanwhile, three more H5N6 outbreaks have been detected in birds from villages in two different provinces, two in Nghe An in the north and one in Kon Tum in the central part of the country. The outbreaks began from August 26 to September 24, and taken together, the virus killed 377 out of 1,422 birds. The survivors were culled and vaccinations were ordered for the birds in the area. Vietnam is among the Asian countries that have reported sporadic H5N6 outbreaks, with the latest reported on 11 September.
1 October OIE report on H5N1 in Vietnam
1 October Report of the OIE on H5N6 in Vietnam

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