Hospitalized COVID-19 patients younger, healthier than flu patients
A study yesterday found that US patients hospitalized with COVID-19 are more likely to be male, younger, and have fewer comorbidities and lower medication use than hospitalized flu patients.
Previous studies of clinical characteristics of COVID-19 hospitalized patients identified higher rates of male patients with varying frequencies of comorbidities, but the prevalence of specific comorbidities and prior medication use among COVID-19 patients is not yet clear.
The study in Nature Communications explored the demographics, medical conditions, and medication use of more than 34,000 hospitalized COVID-19 patients in the United States, Spain, and South Korea, comparing these characteristics with those of 84,585 patients hospitalized with influenza from 2009 to 2019. Because COVID-19 and the flu both cause respiratory disease that can vary in severity and symptoms, flu has been identified as a possible model for identifying COVID-19 risk factors.
Patients hospitalized with COVID-19 were more likely to be older (between 60 to 75 years) and male in the United States and Spain, and more often younger and female in South Korea. COVID-19 patients were also likely to have comorbidities such as high blood pressure (37% to 70% in the US; 30% to 46% in Spain; 24% in South Korea). Use of medications acting on the renin-angiotensin system 30 days before COVID-19 hospitalization was common among all geographic areas (18% to 39% in the US, 27% in Spain, 14% in Korea).
COVID-19 patients tended to be younger, with a higher proportion of men than flu patients. "In the US and Spain, those hospitalised with COVID-19 were generally either of comparable health or healthier than patients hospitalised with influenza," the study authors wrote. Flu patients had higher rates of respiratory disease, cardiovascular disease, and dementia than COVID-19 patients, as well as higher use of corticosteroids and alpha-blocker medications.
"This study has allowed us to better understand the profiles of patients hospitalized with COVID-19," said co-lead author Edward Burn, PhD, in a Columbia University press release. "Despite recent discourse around the supposed poor health and limited life expectancy of COVID-19 patients [before infection], we see COVID-19 patients to be in no worse health than those typically hospitalized with influenza. This further highlights the high rate of mortality among COVID-19 patients," Burn added.
Oct 6 Nat Commun study
Oct 6 Columbia University news release
High rates of infection noted in close COVID-19 contacts in Mexico
A Mexican study yesterday found 42% COVID-19 patients' close contacts were infected with SARS-CoV-2 and exhibited few symptoms, suggesting that asymptomatic transmission may be a significant factor in the spread of the virus.
The study in American Journal of Infection Control evaluated 81 close contacts of 19 COVID-19 patients, screening for SARS-CoV-2 using real-time reverse transcription-polymerase chain reaction (RT-PCR) and rapid antibody testing.
The researchers found that 34 close contacts (42%) of COVID-19 patients were positive for SARS-CoV-2, with 28 contacts manifesting only one or no symptoms (82.4%). Asymptomatic individuals represented 14.7% of the positive close contacts, highlighting the possibility of transmission during the approximately 19-day duration of viral shedding for asymptomatic COVID-19 patients.
The data from this relatively small study demonstrate an R0 value—a measure of the number of people that a single person infects—of 4.3 + 3.8, significantly higher than that identified by previous studies, but with a wide confidence interval.
Notably, close contacts infected with SARS-CoV-2 mostly presented without fever, and exclusively exhibited loss of the sense of smell, conjunctivitis, chest pain, and irritability (P < 0.05) that are not currently in the Mexican operational testing criteria.
The study authors recommend expanding testing criteria to include a wider range of symptoms to combat COVID-19 transmission. "The importance of close vigilance and screening of contacts of COVID-19 confirmed patients, even if they do not meet with that definition should be an essential measure to avoid the disease spreading," the study authors wrote.
Oct 6 Am J Infect Control study
EU lawmakers urge action on antibiotic shortages, development
European lawmakers yesterday called for the European Union (EU) to address antibiotic shortages and antibiotic development as key components of its forthcoming Pharmaceutical Strategy for Europe.
In a letter to European Commission officials Margaritis Schinas and Stella Kyriakides, 30 European Parliament members said the EU should play a bigger role in multilateral discussions to address antibiotic shortages and should adopt an "end-to-end" approach to support development of models to fix the antibiotic development pipeline, while ensuring both sustainable use of antibiotics and equitable and affordable access.
"In this context, the EU should put forward new models that delink the R&I [research and innovation] cost from the prices of products through alternative mechanisms such as milestone prizes," the letter from the MEP Interest Group on Antimicrobial Resistance (AMR) said.
The letter also urged greater emphasis on prevention activities and more research into alternative therapies to reduce reliance on antibiotics, and recommended strengthening of antibiotic manufacturing requirements to reduce the release of antibiotic residues into the environment.
The Pharmaceutical Strategy for Europe aims to ensure Europe's supply of safe and affordable medicines and support the European pharmaceutical industry.
"AMR is a key area where European citizens rightly expect firm European action," they wrote. "As it cannot be tackled efficiently at national level, we call for the Pharmaceutical Strategy to be a stepping stone to an ambitious regulation that would address human, animal, and environmental health in a 'One Health' approach and include non-pharmaceutical aspects such as monitoring and surveillance, infection prevention and control, and access to rapid and affordable diagnostic tools."
Oct 6 MEP Interest Group on AMR letter
