Pandemic deaths hit poor communities harder than rich ones, data show
A new study comparing excess years of life lost (YLL) during the first year of COVID-19 in parts of England and Wales shows that economically deprived areas suffered three times as many deaths as affluent regions, and young adults (15 to 44 years old) were 11 times more likely to die from the virus in poorer parts of the United Kingdom. The study is published in PLOS Medicine.
Though excess deaths have been used as a metric during the pandemic, the researchers from the University of Manchester said excess YLL accounts for the differences in ages at which people die in different social groups and may be a better measure of how seriously a community has been affected by the pandemic.
The authors used national mortality registers in England and Wales from Dec 27, 2014, until Dec 25, 2020, covering 3,265,937 deaths, to measure YLL attributable to the pandemic.
The authors found an average of 1,645 YLL per 100,000 of the population in the most deprived areas, which included London and North Western England, compared with 916 YYL per 100,000 people in the most affluent parts of the country.
"For all-cause mortality, estimated deaths in the most deprived compared to the most affluent areas were much higher in younger age groups, but similar for those aged 85 or over," the authors wrote.
In a press release, lead author Evangelos Kontopantelis, PhD, said, "The impact of the pandemic, when quantified using years of life lost, was higher than previously thought, on the most deprived areas of England and Wales, widening pre-existing health inequalities."
Feb 15 PLOS Med study
Feb 15 PLOS press release
COVID vax–related myocarditis may be milder than that of other causes
While cardiac imaging shows that COVID-19 vaccine–associated myocarditis has a similar pattern as that from other causes, the abnormalities are less severe and result in less functional impairment, suggests a study yesterday in Radiology.
Myocarditis (inflammation of the heart muscle) after vaccination is rare, but some cases have been reported after receipt of the Pfizer/BioNTech or Moderna mRNA COVID-19 vaccine.
University of Toronto researchers retrospectively studied the electronic health records of 92 adults diagnosed as having myocarditis with one or more T1 and T2 abnormalities on cardiac magnetic resonance imaging (MRI) from December 2019 to November 2021.
Among the 92 patients, 22% were diagnosed as having myocarditis within 14 days after COVID-19 vaccination, 11% had myocarditis after COVID-19 illness, and 66% had myocarditis from another cause (non–COVID-19 infection in 31%, autoimmune disorder in 13%, drugs in 10%, hyper-eosinophilic blood disorder in 5%, and other/unknown in 41%).
MRI showed late gadolinium enhancement (LGE) (indicating myocardial injury) in 81% of vaccine-associated myocarditis patients and left ventricular dysfunction in 29%. These patients had higher left ventricular ejection fraction and less extensive LGE after controlling for age, sex, and time between symptom onset and MRI. Septal involvement was less common in this group.
Of patients with vaccine-associated myocarditis, symptom onset occurred after receipt of the Moderna COVID-19 vaccine in 57% of cases and after Pfizer in 43%. Most cases (81%) occurred after the second dose.
Average age was 31 years in the first group, 51 years in the second group, and 44 in the third group. The first group had a higher proportion of men (81%) than the other groups.
Fourteen vaccine patients (67%) were hospitalized for a median of 3 days. After a median of 22 days, all patients with vaccine-associated myocarditis were symptom-free and had no adverse events.
In a Radiological Society of North America (RSNA) news release, coauthor Paaladinesh Thavendiranathan, MD, said that patients should not let fear of myocarditis keep them from being vaccinated against COVID-19. "The risk of myocarditis seems to be much higher following COVID-19 illness," he said. "However, if patients do experience symptoms—especially chest pain—early after COVID-19 vaccination, they should seek medical attention."
Feb 15 Radiology study
Feb 15 RSNA news release
H5 avian flu strikes second Indiana turkey farm
The Indiana Board of Animal Health (IBAH) yesterday said preliminary testing has identified H5 avian flu at a second turkey farm in Dubois County, not far from where a highly pathogenic H5N1 outbreak was confirmed last week.
The newly affected farm is within the 10-kilometer control area of the first farm and was already under quarantine. In the latest outbreak, the farmer noticed a dramatic drop in water consumption, a clinical sign of avian influenza. The farm houses 26,473 turkeys.
Testing is under way to assess if the virus is the same as the H5N1 subtype detected in the first outbreak and if it is highly pathogenic.
The earlier outbreak in Dubois County marked the nation's first highly pathogenic avian flu outbreak in poultry since 2020 and Indiana's first since 2016.
Feb 15 IBAH statement
In international developments, India reported a highly pathogenic H5N1 outbreak in poultry, also its first since 2020, according to a notification from the World Organisation for Animal Health (OIE).
The event began on Jan 18 at a farm in Bihar state in the country's east, killing 787 of 3,859 susceptible birds. So far, the source of the virus hasn't been determined.
Feb 16 OIE report on H5N1 in India