COVID
COVID-19 and
Long-Term Heart Damage:
A three-part journal series, published in the Journal of the American
College of Cardiology takes a deeper
dive into the impact COVID-19 has on the heart. Nearly a quarter of
hospitalized coronavirus patients experience myocardial injury and many develop
arrhythmias or thromboembolic disease. Those with preexisting cardiac
conditions, like hypertension, diabetes, obesity, or high cholesterol, have a
greater risk of worse outcomes with COVID-19.
Study finds
tocilizumab improves survival in critically ill patients with COVID-19: Researchers from 68 sites across the
country found that when tocilizumab was administered within the first two days
of intensive care unit (ICU) admission, there was a 30 percent relative
decrease (and a 10 percent absolute decrease) in mortality compared to patients
whose treatment did not include early use of tocilizumab. JAMA Internal
Medicine
Social
Distancing will probably be in place a year or more: Experts say social or physical
distancing measures against COVID-19 will probably need to remain in place for
at least a year. Until the effectiveness of vaccines are and how many people
get them is known, it’s important to maintain physical distancing as well as
other safety protocols, such as mask wearing.
CDC Plans Cellphone COVID-19 Vaccine Tracking System: When a COVID-19 vaccine becomes available, the U.S.
Centers for Disease Control and Prevention will monitor those taking the
vaccine for any health problems via text messages and online surveys,CNNreported
CDC Broadens
Definition of 'Close Contact' in Tracing COVID-19 Infections: The CDC had previously defined a
"close contact" as someone who spent at least 15consecutiveminutes
within 6 feet of a confirmed COVID-19 case. Now, a close contact will be
defined as someone who was within 6 feet of an infected individual for a total
of 15 minutes or more during a 24-hour period. State and local health
departments rely on this definition to conduct contact tracing.
Immunity
From Antibodies May Decline Rapidly: An ongoing study
led by Imperial College London (ICL) found that the proportion of people
testing positive for COVID-19 antibodies dropped by 26.5% over a 3 month period
between June and September. The findings from a non-peer reviewed preprint
suggested that infection with SARS-CoV-2 confers only limited protection
against re-infection.
COVID-19
Infection Fatality Ratio Is About 1.15%, Study Says: A new
study conducted by researchers at Imperial College London found the
COVID-19 infection fatality ratio is about 1.15% of infected people in
high-income nations and 0.23% in low-income nations. The new study confirms
that the coronavirus is deadlier for older people, with the risk of death
doubling for every eight years of aging and ranging from 0.1% for people under
40 and 5% among people over 80 years old.
Don’t Use
N95s for More than 2 Days:
When reused for more than 2 days, nearly half of N95 masks fail, new research
shows. Medscape
Famotidine
Has Uncertain Impact on COVID-19 Mortality: Famotidine use within 24 hours of admission does not
improve but may worsen 30-day mortality of patients hospitalized with COVID-19,
according to a retrospective study. At least two previous studies have reported
an association between in-hospital famotidine use and reduced risk of death or
intubation in patients with COVID-19. Gastroenterology
Wear a Mask
Inside Your Household at First Sign of COVID: The CDC's Morbidity
and Mortality Weekly Report
says more than 100 households in Nashville and Marshfield, WI, were
studied from April to September to determine the rate of COVID transmission
within a household. Fifty-three percent of people living with somebody
who tested positive ended up becoming infected themselves within a week, with
75% of the secondary infections confirmed within 5 days or less, the CDC
said. "Because prompt isolation of persons with COVID-19 can reduce
household transmission, persons who suspect that they might have COVID-19
should isolate, stay at home, and use a separate bedroom and bathroom if
feasible," the study said
Low-Dose
Radiotherapy for Lung Inflammation in Severe COVID-19: The first study to suggest benefit from
low-dose radiotherapy for severe COVID-19–induced pneumonia involved only 10
patients with this condition, but the results were so promising that two larger
randomized trials are now underway. American Society for Radiation Oncology
(ASTRO) 2020 Annual Meeting
COVID-19 is
making tinnitus worse, new study finds: New research reveals that tinnitus, a common condition
that causes the perception of noise in the ear and head, is being exacerbated
by COVID-19—as well as the measures helping to keep us safe. Frontiers in
Public Health
COVID-19:
Quicker recovery may indicate long-term immunity: Researchers recently found that some
people who recovered quickly from COVID-19 continued to have antibodies against
SARS-CoV-2 for several months. This discovery suggests the potential for
long-term protection among those with a strong initial immune response. Cell.
Aspirin May
Help Covid Patients:
Now research indicates aspirin may help COVID patients survive by helping to
prevent those blood clots. A study overseen by the University of Maryland
School of Medicine showed that COVID patients had fewer complications when they
took aspirin. Anesthesia
and Analgesia
Antiviral
Mouthwash Could Help Curb Coronavirus Transmission: Mouthwashes with antiviral ingredients
could help decrease COVID-19 transmission by reducing viral loads in the mouths
of infected patients when they cough, sneeze or speak, according to a paper in
the Journal of Dental Research. Studies have found that rinses containing
cetylpyridinium chloride or povidone-iodine can reduce the oral coronavirus
load; other promising compounds include hydrogen peroxide, chlorhexidine,
cyclodextrin, Citrox, and certain essential oils. While more studies are needed
to determine appropriate regimens, it’s suggested using three doses of
antiviral mouthwash the day before a meeting, and one dose the morning of the
event. COVID-19 patients should be using mouthwash regularly for seven to 10
days.
Pfizer
Vaccine Data Show 90% Efficacy in Early Results: A vaccine candidate against SARS-CoV-2
has been found to be 90% effective in preventing COVID-19 in trial volunteers
who were without evidence of prior infection of the virus, results from an
interim analysis of a phase 3 study demonstrated. press
release
Cleveland
Clinic researchers identify melatonin as possible COVID-19 treatment: Analysis of patient data from Cleveland
Clinic's COVID-19 registry also revealed that melatonin usage was associated
with a nearly 30 percent reduced likelihood of testing positive for SARS-CoV-2
(the virus that causes COVID-19) after adjusting for age, race, smoking history
and various disease comorbidities. Notably, the reduced likelihood of testing
positive for the virus increased from 30 to 52 percent for African Americans
when adjusted for the same variables. PLOS Biology
COVID-19
survival among elderly patients could be improved by arthritis drug : Baricitinib, a type of arthritis
drug, may reduce the risk of dying for
elderly patients with COVID-19. Science Advances
Osteoporosis
Drugs Don't Worsen COVID-19 Risk, May Help: Findings from the cross-sectional study
of 2102 patients with osteoporosis, osteoarthritis,
and/or fibromyalgia
— so-called noninflammatory rheumatic conditions — during March 1 to May 3,
2020 were recently
published in Aging.
Patients taking denosumab,
zoledronate, and calcium showed trends toward lower incidence of developing
symptomatic presumed COVID-19 (PCR tests weren't widely available at the time),
as did those taking the antidepressant serotonin/norepinephrine
inhibitor duloxetine.
Some analgesics, particularly pregabalin
and most other antidepressants, were associated with higher incidences of
COVID-19, while oral bisphosphonates, vitamin
D, thiazide diuretics, antihypertensive drugs, and chronic nonsteroidal
anti-inflammatory drugs had no effect on COVID-19 incidence.
Masks don't
impair lung function during physical activity, study finds: While they might feel uncomfortable,
facemasks do not significantly change the actual work of breathing or the flow
of oxygen and carbon dioxide when worn while exercising, researchers report. Annals of the American Thoracic Society
Immune Protection Against Severe COVID-19 Reinfection Appears Lasting: Regardless of their
detectable antibody levels, most COVID-19 survivors are likely to have lasting
protection against severe COVID-19 if they become reinfected, thanks to other
components of the body's immune response that remember the new coronavirus in
different ways, researchers say. The new findings "suggest that the immune
system can remember the virus for years, and most people may be protected from
severe COVID-19 for a substantial time." bioRxiv , online November 16, 2020
PAIN
Knee or hip replacements cut people's
risk for falls, study finds:
People who have total joint replacement, or total joint arthroplasty (TJA),
experience fewer falls than those who don't undergo the surgery, a new study
finds. Journal of the American Academy of Orthopaedic Surgeons
Steroid
injections do not hasten the need for knee replacement: New research shows that corticosteroid
injections for knee OA treatment do not hasten a patient's progression to a
total knee replacement when compared with hyaluronic acid injections. Details
of this study was presented at ACR Convergence. (ABSTRACT #1652).
Warfarin use
significantly increases risk of knee and hip replacement in people with OA: New research presented at ACR
Convergence, shows that use of warfarin, a vitamin K drug widely prescribed to
prevent blood clots, is associated with a significantly greater risk of knee
and hip replacements in patients with osteoarthritis (ABSTRACT #0934).
Novel
technique 'stuns' arthritis pain in shoulder and hip: A interventional radiology treatment
known as cooled radiofrequency ablation (c-RFA)
was tested for pain relief in the setting of advanced degenerative
arthritis. The procedure involves the placement of needles where the main
sensory nerves exist around the shoulder and hip joints. The nerves are then
treated with a low-grade current known as radiofrequency that "stuns"
them, slowing the transmission of pain to the brain. "In our study, the
results were very impressive and promising," Dr. Gonzalez said. "The
patients with shoulder pain had a decrease in pain of 85%, and an increase in
function of approximately 74%. In patients with hip pain, there was a 70%
reduction in pain, and a gain in function of approximately 66%." The
procedure offers a new alternative for patients who are facing the prospect of
surgery. In addition, it can decrease the risk of opiate addiction.
Radiological Society of North America (RSNA) Meeting
COMPLEMENTARY & ALTERNATIVE MEDICINE
CBD: It Won’t
Cure Ailments but It Can Help with Pain, Nausea: According to a new studyTrusted
Source that analyzed years of user comments on Reddit to
determine the effectiveness on health and wellness of this active compound
found in cannabis plants,there is no evidence that cannabidiol (CBD) can cure
medical ailments. However,
they said some research has shown that it can be effective in reducing pain and
nausea.
Cannabis use
prompts need for more anesthesia during surgery, increases pain: Not only might cannabis users require
more anesthesia during surgery than non-users, they may have increased pain
afterwards and use higher doses of opioids while in the hospital, suggests
first-of-its kind research being presented at the ANESTHESIOLOGY® 2020 annual
meeting.
Acupuncture
before surgery means less pain, significantly fewer opioids for Veterans: Veterans who have acupuncture before
surgery report less pain and need far fewer opioids to manage their discomfort,
according to a randomized, controlled study being presented at the
ANESTHESIOLOGY® 2020 annual meeting. Veterans who received acupuncture also
reported they were more satisfied with their pain control than those who did
not.
Complementary
and alternative medicine for veterans and military personnel -- update from
Medical Care: A growing
body of research evidence shows that complementary and alternative medicine
(CAM) has health benefits for US military veterans and active duty personnel,
according to a special December supplement to Medical Care.
FDA ACTION
• Approved
Sklice (ivermectin) be switched from prescription to over-the-counter for
patients 6 months and older
• Approved
emergency use authorization for casirivimab and imdevimabe to be administered
together for the treatmet of mild to moderate Covid-19
• Approved
Zokinvy (lonafarnib) capsules to reduce the risk of death due to
Hutchinson-Gilford progeria syndrome
• Approved
emergency use authorization or the first COVID-19 diagnostic test for
self-testing at home and that provides rapid results.
• Approved
emergency use authorization for the investigational monoclonal antibody therapy
bamlanivimab for the treatment of mild-to-moderate COVID-19 in adult and
pediatric patients
• Permitted
marketing of a new device intended for the temporary reduction of sleep
disturbance related to nightmares in adults 22 years or older who suffer from
nightmare disorder or have nightmares from post-traumatic stress disorder
(PTSD). The device provides gentle vibration through touch based on an analysis
of heart rate and motion during sleep.
• Approved a
lotion to treat head lice for nonprescription, or over-the-counter (OTC), use
through a process called a prescription (Rx)-to-OTC switch.
• Approved
the antiviral drug Veklury (remdesivir) for use in adult and pediatric patients
12 years of age and older for Covid-19
PREVENTION: Exercise
Bursts of
exercise can lead to significant improvements in indicators of metabolic health: Short bursts of physical exercise
induce changes in the body's levels of metabolites that correlate to, and may
help gauge, an individual's cardiometabolic, cardiovascular and long-term
health, a study by Massachusetts General Hospital (MGH) has found. In a paper
published in Circulation, the research team describes how
approximately 12 minutes of acute cardiopulmonary exercise impacted more than
80% of circulating metabolites, including pathways linked to a wide range of
favorable health outcomes, thus identifying potential mechanisms that could
contribute to a better understanding of cardiometabolic benefits of exercise.
PREVENTION: Diet/Nutrition
High
flavanol diet may lead to lower blood pressure: People who consume a diet including
flavanol-rich foods and drinks, including tea, apples and berries, could lead
to lower blood pressure. Scientific Reports
Drinking green
tea and coffee daily linked to lower death risk in people with diabetes: Drinking plenty of both green tea and
coffee is linked to a lower risk of dying from any cause among people with type
2 diabetes. BMJ Open Diabetes Research & Care
Eliminating
Processed Foods Could Slash Your Risk of Death from Heart Disease: 2 out of every 3 deaths from heart
disease could be prevented by adopting a healthier diet, researchers say in a new study. “More than 6 million deaths could be avoided by
reducing intake of processed foods, sugary beverages, trans and saturated fats,
and added salt and sugar, while increasing intake of fish, fruits, vegetables,
nuts, and whole grains.”
Eating less
suppresses liver cancer due to fatty liver: An international research team led by Shinshu University
School of Medicine were able to show that reducing food intake by 30%, or
eating until you are just 70% full is effective in reducing the likelihood of
developing liver cancer from fatty liver.
People
with type 2 diabetes need not avoid eating potatoes based on glycemic index New study findings show that people with type
2 diabetes can better maintain overnight glycemic control when high Glycemic
Index (GI) potatoes are included in an evening meal versus low GI basmati rice.
Clinical Nutrition
All weight
loss isn't equal for reducing heart failure risk: Reducing the level of body fat and
waist size are linked to a lower risk of heart failure in patients with type 2
diabetes. Circulation
Chili Peppers Might Extend Your Life:
Preliminary research shows that eating chili pepper may reduce your risk of
death from heart disease, cancer and other causes, building on past studies
that have found chili pepper to have health benefits. American Heart
Association Meeting Nov. 13 to 17
A few
kilograms weight loss nearly halves the risk of diabetes: Losing a few kilograms in weight almost
halves people's risk of developing Type 2 diabetes - according to a large scale
research study. The research shows how providing support to help people with
prediabetes make small changes to their lifestyle, diet and physical activity
can almost halve the risk of developing Type 2 diabetes. The findings come from
the largest diabetes prevention research study in the world in the last 30
years. The clinical trial involved >1,000 people with prediabetes. JAMA
Internal Medicine
Go (over)
easy on the eggs:
'Egg-cess' consumption linked to diabetes: The longitudinal study (1991 to
2009) is the first to assess egg consumption in a large sample of Chinese
adults. It found that people who regularly consumed one or more eggs per day
(equivalent to 50 grams) increased their risk of diabetes by 60 per cent.
PREVENTION:
VITAMINS/SUPPLEMENTS
Vitamin D
lessens symptoms of severe eczema in children: Vitamin D supplementation eased the symptoms experienced
by children with severe atopic dermatitis, or eczema, in a recent randomized
controlled trial published in Pharmacology Research & Perspectives.
Multinutrient
Intervention Slows Cognitive Decline in Alzheimer Disease: For individuals with prodromal
Alzheimer disease, a multinutrient intervention can slow cognitive decline,
according to a study recently published in Alzheimer's
& Dementia.
NIH Dietary
Supplements for Eye Conditions
There is evidence that a combination of vitamins E and C, beta-carotene, and
zinc (known as the AREDS formulation) may reduce the risk of developing
advanced AMD. There is also some limited evidence that for less well-nourished
populations, the carotenoids lutein/zeaxanthin may be associated with a
reduction in progression to cataract surgery; however, whether supplementation
would be beneficial for this population requires further study. Current data do
not support the use of dietary supplementation with vitamins A, C, and E, or
cannabinoids, as treatment for glaucoma. More information about the AREDS
formulation for AMD is available from the National Eye Institute.
Fish Oil,
Vitamin D Supplements Won't Prevent A-Fib: A new study finds the nutrients won't shield against the
common and potential heart rhythm disorder known as atrial fibrillation. The
results do provide reassurance that these supplements do not increase the
overall risk of atrial fibrillation and appear to be generally safe for
patients who are taking these supplements for other reasons. Annual AHA meeting
Study Finds
Fish Oil May Not Help Your Heart:
New research from the Cleveland Clinic has found that common types of fish oil
may not be as beneficial for the heart as they were once thought to be. The studyTrusted Source, published in the Journal of the
American Medical Associationon November 15, found that a high dose of omega-3
fatty acids did not reduce people’s chances of experiencing a major
cardiovascular event. Evidence regarding
the use of fish oil for heart health has been mixed. Oftentimes, the results
are influenced by the type of fish oil and the type of placebo used. “For
patients ’fishing for answer on fish oil,’ the current data supports purified
EPA prescription fish oil Vascepa as opposed to over-the-counter fish oil, low
dose fish oil, and combination DHA and EPA fish oil.
Multivitamins
Don’t Provide Many Health Benefits, Researchers Say: There’s scant evidence that
multivitamins or mineral supplements have any positive impact on health, except
for people with known vitamin or mineral deficiencies. And while taking daily
vitamins may make you feel better, in most cases that’s likely just the placebo
effect at work, a new study suggests. The research,
published in the journal BMJ Open, compared self-reported and clinically
measurable health outcomes among a group of more than 21,000 multivitamin users
and nonusers in the United States.
PREVENTION
Residential
area may impact risk of chronic conditions: Where you live may increase your risk for uncontrolled
diabetes, high blood pressure, obesity, and depression, according to a study.
Results indicate that local and regional factors significantly affect
individuals with chronic health conditions. Journal of the American Medical Association.
Could hard
physical labor increase dementia risk?: The rate of dementia in men who once had jobs that
involved tough physical work is almost one and a half times greater than in
those whose work was sedentary, a study has found. Scandinavian Journal of Medicine & Science in Sports.
Rate ofMemory Decline Greater for Mothers Who Do Not Work for Pay: Women whose work-family profiles do not
include working for pay after childbearing have a greater rate of memory
decline after age 60 years than working mothers, according to a study published
online Nov. 4 in Neurology.
Positive
outlook predicts less memory decline:
A new study finds that people who feel enthusiastic and cheerful -- what
psychologists call 'positive affect' -- are less likely to experience memory
decline as they age. This result adds to a growing body of research on positive
affect's role in healthy aging. Psychological
Science
Combo pill
alone and with aspirin lowers heart disease risk: A 'polypill' is a single pill
that includes multiple medications to control more than one health risk factor
(such as heart disease, high blood pressure, high cholesterol, Type 2 diabetes,
kidney disease, stroke). In this large, international trial, the polypill
included blood pressure and cholesterol lowering medications for people at risk
for heart disease. Results from the randomized, placebo-controlled trial show
that the combination of a polypill plus aspirin reduced cardiovascular disease
by 31%, and the polypill without aspirin reduced CVD by 21%. NEJM
TREATMENT
Cholesterol medications linked to lower cancer-related deaths in women: Among women with breast cancer,
colorectal cancer, or melanoma, those who were taking cholesterol-lowering
medications, were less likely to die from cancer. British Journal of
Clinical Pharmacology.
Steroid inhalers / pills for asthma linked to heightened risk of brittle bones andfractures: Taking
steroid inhalers or tablets to treat asthma or control flare-ups is linked to a
heightened risk of brittle bones (osteoporosis) and increased vulnerability to
broken bones (fragility fractures). Thorax.
34% of older
adults in the US are prescribed potentially inappropriate drugs: The prescription of potentially
inappropriate medications to older adults is linked to increased
hospitalizations, and it costs patients, on average, more than $450 per year. Journal of the American Geriatrics
Society
Steroid
inhalers/pills for asthma linked to heightened risk of brittle bones and
fractures: Taking
steroid inhalers or tablets to treat asthma or control flare-ups is linked to a
heightened risk of brittle bones (osteoporosis) and increased vulnerability to
broken bones (fragility fractures), finds new research. BMJ
Hydroxychloroquine
not linked to longer heart rhythm intervals in RA or lupus patients: New research presented at ACR
Convergence, the American College of Rheumatology's annual meeting, discovers
that use of hydroxychloroquine, a generic drug, does not cause any significant
differences in QTc length or prolonged QTc, key measures of heart rate, in
people with rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE) (ABSTRACT #0431).
Osteoporosis
is underdiagnosed and undertreated in older men A new study reveals that many older men
who experience a fracture are still underdiagnosed with and undertreated for
osteoporosis. Details of the study was presented at ACR Convergence, the
American College Rheumatology's annual meeting (ABSTRACT #0533).
Romosozumab
substantially builds bone density in hip and spine: New research presented at ACR
Convergence, the American College Rheumatology's annual meeting, reveals that
romosozumab, an osteoporosis drug, produces substantial gains in bone mineral
density in the hip and lumbar spine within one year, and that transitioning patients
to a potent antiresorptive drug can lead to even more bone density gains (ABSTRACT #1973).
Combo-drug
treatment for Type 2 diabetes remains effective after two years: Patients with Type 2 diabetes often
take metformin as first-line therapy to help stabilize their blood glucose.
Eventually, some patients no longer respond to metformin and require additional
treatment. A few years ago, pivotal short-term trials showed that a combination
of two drugs controlled diabetes progression better than either single drug
alone. Now, new research demonstrates that this drug combo of dapagliflozin and
exenatide continues to stay effective, without loss of effect, after two years
of continual use. Diabetes Care.
Older adults
are at greater risk of cardiovascular events than younger people, and benefit
at least as much from cholesterol-lowering medications, two studies suggest:
An observational study finds risk of heart attack and cardiovascular
disease is highest in people aged 70 and over with elevated levels of LDL
cholesterol, compared to younger age groups, and estimates the number needed to
treat with statins to prevent one heart attack in five years is lowest in
people aged 70 to 100 years. A separate systematic review and meta-analysis
including data from more than 21,000 people aged 75 years and older finds LDL
cholesterol-lowering therapies (including statins) are as effective at reducing
cardiovascular events (including stroke and heart attack) in this age group as
they are in younger people. Lancet
New Cancer Drug
Approvals Linked to Drop in Mortality: For the most common cancers, cancer drug
approvals between 2000 and 2016 were associated with a reduction in deaths,
according to a study published online Nov. 9 in the Journal of Medical Economics.
Panel Recommends Against Approval of Experimental Drug for Alzheimer Disease: An experimental Alzheimer disease
treatment should not be approved by the U.S. Food and Drug Administration, an
agency advisory panel says. The panel reviewed clinical data on the drug
aducanumab and concluded that there is not enough evidence to support its
clinical effectiveness, CNN reported. The drug, developed by the pharmaceutical
company Biogen and its Japanese partner Eisai, is administered through
intravenous infusion for early Alzheimer disease.
Diabetes
drug can treat and reverse heart failure and reduce: Empagliflozin, a recently developed
diabetes drug, can effectively treat and reverse heart failure in both diabetic
and non-diabetic patients. Journal of the American College of Cardiology
OTHER
Suffering in
silence: two-thirds of older adults say they won't treat their depression: A new nationwide poll, the GeneSight
Mental Health Monitor, shows that nearly two-thirds (61%) of Americans age 65
or older who have concerns about having depression will not seek treatment. In
fact, nearly 1 in 3 (33%) seniors who are concerned they might be suffering
from depression believe they can "snap out" of it on their own.
