Weekly Covid-19 Update: Tuesday, September 7, 2021
Happy Tuesday, everyone. Here’s the latest in Covid research. This week I’m summarizing studies focused on post-Covid kidney damage, autoantibodies and severe Covid, effectiveness of masks from a large-scale study involving 342,000 people, long Covid and breakthrough cases, data on children and adolescents, and as always a world update.
1) A study of nearly 90,000 Covid survivors showed that between 1–6 months after infection this group was at 35% greater risk of adverse kidney issues than the study’s control group of 1.6 million individuals who never had Covid. Covid survivors were at greater risk of acute kidney injury (AKI — a condition that can range from minor loss of kidney function to total kidney failure), eGFR decline (a signal that a person has underlying kidney disease), end-stage kidney disease (ESKD), and major adverse kidney events (MAKE). The study was based on data from patients in the US Veterans Affairs (VA) health system. One limitation of the study was that it overwhelmingly involved older white male subjects. The researchers concluded, “The totality of the evidence suggests that substantial risk of kidney outcomes in people with COVID-19 and highlights the need to integrate a kidney care component in post-acute COVID care pathways.” The study was peer-reviewed and published in the Journal of the American Society of Nephrology. You can read the full text here: https://jasn.asnjournals.org/content/early/2021/08/25/ASN.2021060734
2) In a previous update (apologies, as I can’t remember which month it was from!) I wrote about research on autoantibodies (antibodies that turn against elements of one’s own immune defenses) that were thought to cause severe Covid as opposed to being a consequence of the virus. New peer-reviewed research published in the journal Science Immunology provides evidence to support the initial findings. The first part of the research involved studying the blood of over 3,000 critically ill Covid-19 patients, of which 13.6% were found to have the rare autoantibodies. For those over the age of 80 this number was 21%. Researchers also tested blood samples taken before the pandemic from nearly 35,000 healthy individuals for autoantibodies. Results showed that the prevalence of autoantibodies increased significantly with age in the general population. They were present in 0.18% of people between ages 18–69, 1.1% of those aged 70–79, and 3.4% of those over the age of 80. The researchers concluded that autoantibodies help to explain the increased risk of critical Covid-19 in the elderly population. The researchers stated that it is “quick and easy” for Covid patients to be tested for these autoantibodies and it is also possible that the general public could be screened for them before infection. Additionally, the recommended that plasma donors be screened for these autoantibodies. You can read the full study here: https://www.science.org/doi/10.1126/sciimmunol.abl4340
3) Are we still debating the effectiveness of masks in preventing the spread of Covid-19? Apparently so, therefore researchers conducted a study of over 342,000 adults from 600 villages in rural Bangladesh to better understand the effectiveness of masks. Approximately 178,000 individuals from 300 villages were part of the intervention group and they were given free masks, educated on the importance of mask-wearing, and given in-person reminders for eight weeks. The other group of nearly 164,000 individuals from the other 300 villages did not receive masks nor education or reminders. Over the eight weeks of the study, mask wearing increased 42.3% in the villages with the intervention compared to just 13.3% in the control villages. Blood samples showed that the intervention villages had 9.3% fewer cases of symptomatic Covid than the control (non-mask wearing) villages, as well as an 11.9% reduction in Covid symptoms. The authors concluded, “Our intervention demonstrates a scalable and effective method to promote mask adoption and reduce symptomatic SARS-CoV-2 infections.” The study is currently undergoing peer review at the journal Science and a pre-print is available here: https://www.poverty-action.org/sites/default/files/publications/Mask_RCT____Symptomatic_Seropositivity_083121.pdf
4) Data show that vaccinated individuals who experience breakthrough cases of Covid-19 are 50% less likely to develop long Covid than those who are not vaccinated. A peer-reviewed study published in The Lancet Infectious Diseases used data from 1.2 million individuals, of whom 971,504 were fully vaccinated and the rest had received only one vaccine dose. In total, 6,050 (0.5%) became infected with Covid-19. Of that number, 2,370 were from the fully vaccinated group. Risk factors of breakthrough infection included people with only one vaccine dose who were over the age of 60, and those who received one vaccine dose and were living in a highly depraved area. Additionally, individuals who received only one vaccine dose and were not classified as obese were associated with lower risk of infection. The study stated, “Almost all symptoms were reported less frequently in infected vaccinated individuals than in infected unvaccinated individuals, and vaccinated participants were more likely to be completely asymptomatic, especially if they were 60 years or older.” You can read the full study here: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(21)00460-6/fulltext
5) Data on case numbers, emergency room visits, and hospitalizations of children and adolescents aged 0–17 over a one-year period (August 2020 to August 2021) were recently published in the CDC’s Morbidity and Mortality Weekly Report (MMWR). Findings showed that between June and August 2021, all three increased in the United States. Hospitalizations were more prevalent amongst children under the age of 4 and adolescents between the ages of 12–17. Additionally, the study found that “emergency department visits and hospital admissions in a 2-week period in August 2021 were higher in states with lower population vaccination coverage and lower in states with higher vaccination coverage.” During this time period hospitalizations in children and adolescents increased four times in states with the lowest vaccination levels (Alabama, Arkansas, Georgia, Idaho, Louisiana, Mississippi, Missouri, North Dakota, Oklahoma, South Carolina, Tennessee, West Virginia, and Wyoming). As children are now going back to school, the report recommended multiple prevention measures in childcare settings and schools such as masking for students and staff and maintaining proper ventilation. The researchers concluded, “Community vaccination, in coordination with testing strategies and other prevention measures, is critical to protecting pediatric populations from SARS-CoV-2 infection and severe COVID-19.” You can read the full study here: https://www.cdc.gov/mmwr/volumes/70/wr/mm7036e1.htm?s_cid=mm7036e1_w
6) Now for your world update. I’ll start with the US, where the total number of known Covid cases since the pandemic began just surpassed 40 million today. Over the past two weeks the average number of new daily cases is 132,135 (a 12% decrease over the past 14 days), hospitalizations are averaging 101,747 per day (8% increase), and there are an average of 1,385 daily deaths (31% increase). Of those eligible for vaccination (age 12 and up), 62% of the US population is fully vaccinated. In terms of state trends, South Carolina is averaging the highest number of infections per capita with 107 per 100K, followed by Alabama at 88 per 100K, West Virginia with 85/100K, and Mississippi with 82/100K. Not surprisingly, these states are also amongst the least vaccinated in the country. The states with the lowest current rate of infection include Connecticut (12 cases per 100K), New Hampshire (13/100K), Washington DC (13/100K), Michigan (15/100K), and Massachusetts (15/100K).
— In the UK there were 40,801 new infections yesterday and there has been a 14% increase in daily cases over the past two weeks. The UK is currently averaging 113 deaths per day, a 13% increase over the past two weeks. In terms of vaccinations, 79% of eligible people in England (age 16 and up) have been fully vaccinated and 88% have received at least one dose. Wales leads the way in vaccinations with 84% of those eligible receiving both doses and 90% receiving at least one dose.
— Elsewhere, health officials in Chile have approved the Sinovac vaccine for children as young as age 6. In Vietnam a man was sentenced to five years in jail after breaking strict Covid quarantine restrictions and infecting at least eight others. New Zealand is experiencing a decrease in cases after recent outbreaks of the Delta variant, with just 21 new cases reported yesterday, all of which were in Auckland. In Australia active cases are increasing in New South Wales (1,220 new cases yesterday) and Victoria (246), while they are decreasing in all other states. Of the Australian population age 16 or older, 38.75% are fully vaccinated.
US numbers: https://www.nytimes.com/interactive/2021/us/covid-cases.html
UK numbers: https://www.nytimes.com/interactive/2021/world/united-kingdom-covid-cases.html
UK vaccinations: https://www.bbc.co.uk/news/health-55274833
World updates: https://www.theguardian.com/world/live/2021/sep/07/coronavirus-live-news-chile-approves-sinovac-for-children-six-and-older-vietnam-jails-man-who-breached-quarantine?page=with:block-613711fe8f08ae40875ab0e4#liveblog-navigation
Australian numbers: https://www.theguardian.com/australia-news/live/2021/sep/07/australia-covid-live-update-nsw-hospitals-brace-for-cases-surge-grace-tame-to-address-womens-safety-summit-victoria-coronavirus-tests-gladys-berejiklian-daniel-andrews-exposure-sites-scott-morrison
That’s all for this week. Thank you as always for reading. Please feel free to share this with anyone who may find it useful.