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Flu shot represents a 36% increased risk of coronavirus infection
Influenza vaccination and respiratory virus interference among Department of Defense personnel during the 2017–2018 influenza season
Abstract
Purpose
Receiving influenza vaccination may increase the risk of other respiratory viruses, a phenomenon known as virus interference. Test-negative study designs are often utilized to calculate influenza vaccine effectiveness. The virus interference phenomenon goes against the basic assumption of the test-negative vaccine effectiveness study that vaccination does not change the risk of infection with other respiratory illness, thus potentially biasing vaccine effectiveness results in the positive direction. This study aimed to investigate virus interference by comparing respiratory virus status among Department of Defense personnel based on their influenza vaccination status. Furthermore, individual respiratory viruses and their association with influenza vaccination were examined.
Results
We compared vaccination status of 2880 people with non-influenza respiratory viruses to 3240 people with pan-negative results. Comparing vaccinated to non-vaccinated patients, the adjusted odds ratio for non-flu viruses was 0.97 (95% confidence interval (CI): 0.86, 1.09; p = 0.60). Additionally, the vaccination status of 3349 cases of influenza were compared to three different control groups: all controls (N = 6120), non-influenza positive controls (N = 2880), and pan-negative controls (N = 3240). The adjusted ORs for the comparisons among the three control groups did not vary much (range: 0.46–0.51).
Conclusions
Receipt of influenza vaccination was not associated with virus interference among our population. Examining virus interference by specific respiratory viruses showed mixed results. Vaccine derived virus interference was significantly associated with coronavirus and human metapneumovirus; however, significant protection with vaccination was associated not only with most influenza viruses, but also parainfluenza, RSV, and non-influenza virus coinfections.
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Endocrine and metabolic link to coronavirus infection
Type 2 diabetes mellitus and hypertension are the most common comorbidities in patients with coronavirus infections. Emerging evidence demonstrates an important direct metabolic and endocrine mechanistic link to the viral disease process. Clinicians need to ensure early and thorough metabolic control for all patients affected by COVID-19.
Type 2 diabetes mellitus (T2DM) seems to be a risk factor for acquiring the new coronavirus infection. Indeed, T2DM and hypertension have been identified as the most common comorbidities for other coronavirus infections, such as severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS-CoV)1. According to several reports, including those from the Centers for Disease Control and Prevention (CDC), patients with T2DM and the metabolic syndrome might have up to ten-times greater risk of death when they contract COVID-19 (CDC coronavirus reports). Although T2DM and the metabolic syndrome increase the risk of more severe symptoms and mortality in many infectious diseases, there are some additional specific mechanistic aspects in coronavirus infections that require separate consideration, which will have clinical consequences for improved management of patients who are severely affected.
Hyperglycaemia and a diagnosis of T2DM are independent predictors of mortality and morbidity in patients with SARS1. This finding could be due to these patients having a state of metabolic inflammation that predisposes them to an enhanced release of cytokines. For COVID-19, a cytokine storm (that is, greatly elevated levels of inflammatory cytokines) has been implicated in the multi-organ failure in patients with severe disease3.
Metabolic inflammation will also compromise the immune system, reducing the body’s ability to tackle the infection, impairing the healing process and prolonging the recovery. An animal model demonstrated that comorbid T2DM results in immune dysregulation and enhances disease severity following MERS-CoV infection2. In this work, diabetic mice expressing the human DPP4 (resulting in MERS-CoV susceptibility) exhibited an altered profile of cytokines, with increased expression of IL-17α following infection. These data support the hypothesis that the combination of coronavirus infection and T2DM triggers a dysregulated immune response, resulting in a more aggravated and prolonged lung pathology2.
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Admission hyperglycaemia as a predictor of mortality in patients hospitalized with COVID-19 regardless of diabetes status: data from the Spanish SEMI-COVID-19 Registry
BACKGROUND: Hyperglycaemia has emerged as an important risk factor for death in coronavirus disease 2019 (COVID-19). The aim of this study was to evaluate the association between blood glucose (BG) levels and in-hospital mortality in non-critically patients hospitalized with COVID-19. METHODS: This is a retrospective multi-centre study involving patients hospitalized in Spain. Patients were categorized into three groups according to admission BG levels: <140 mg/dL, 140-180 mg/dL and >180 mg/dL. The primary endpoint was all-cause in-hospital mortality. RESULTS: Of the 11,312 patients, only 2128 (18.9%) had diabetes and 2289 (20.4%) died during hospitalization. The in-hospital mortality rates were 15.7% (<140 mg/dL), 33.7% (140-180 mg) and 41.1% (>180 mg/dL), p<.001. The cumulative probability of mortality was significantly higher in patients with hyperglycaemia compared to patients with normoglycaemia (log rank, p<.001), independently of pre-existing diabetes. Hyperglycaemia (after adjusting for age, diabetes, hypertension and other confounding factors) was an independent risk factor of mortality (BG >180 mg/dL: HR 1.50; 95% confidence interval (CI): 1.31-1.73) (BG 140-180 mg/dL; HR 1.48; 95%CI: 1.29-1.70). Hyperglycaemia was also associated with requirement for mechanical ventilation, intensive care unit (ICU) admission and mortality. CONCLUSIONS: Admission hyperglycaemia is a strong predictor of all-cause mortality in non-critically hospitalized COVID-19 patients regardless of prior history of diabetes. KEY MESSAGE Admission hyperglycaemia is a stronger and independent risk factor for mortality in COVID-19. Screening for hyperglycaemia, in patients without diabetes, and early treatment of hyperglycaemia should be mandatory in the management of patients hospitalized with COVID-19. Admission hyperglycaemia should not be overlooked in all patients regardless prior history of diabetes.
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Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection?
Human pathogenic coronaviruses (severe acute respiratory syndrome coronavirus [SARS-CoV] and SARS-CoV-2) bind to their target cells through angiotensin-converting enzyme 2 (ACE2), which is expressed by epithelial cells of the lung, intestine, kidney, and blood vessels.4 The expression of ACE2 is substantially increased in patients with type 1 or type 2 diabetes, who are treated with ACE inhibitors and angiotensin II type-I receptor blockers (ARBs).4 Hypertension is also treated with ACE inhibitors and ARBs, which results in an upregulation of ACE2.5 ACE2 can also be increased by thiazolidinediones and ibuprofen. These data suggest that ACE2 expression is increased in diabetes and treatment with ACE inhibitors and ARBs increases ACE2 expression. Consequently, the increased expression of ACE2 would facilitate infection with COVID-19. We therefore hypothesise that diabetes and hypertension treatment with ACE2-stimulating drugs increases the risk of developing severe and fatal COVID-19.
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Almost 90% of COVID-19 Admissions Involve Comorbidities
The hospitalization rate for COVID-19 is 4.6 per 100,000 population, and almost 90% of hospitalized patients have some type of underlying condition, according to the Centers for Disease Control and Prevention.
Data collected by the newly created COVID-19–Associated Hospitalization Surveillance Network (COVID-NET) put the exact prevalence of underlying conditions at 89.3% for patients hospitalized during March 1-30, 2020, Shikha Garg, MD, of the CDC's COVID-NET team and associates wrote in the MMWR.
The hospitalization rate, based on COVID-NET data for March 1-28, increased with patient age. Those aged 65 years and older were admitted at a rate of 13.8 per 100,000, with 50- to 64-year-olds next at 7.4 per 100,000 and 18- to 49-year-olds at 2.5, they wrote.
The patients aged 65 years and older also were the most likely to have one or more underlying conditions, at 94.4%, compared with 86.4% of those aged 50-64 years and 85.4% of individuals who were aged 18-44 years, the investigators reported.
Hypertension was the most common comorbidity among the oldest patients, with a prevalence of 72.6%, followed by cardiovascular disease at 50.8% and obesity at 41%. In the two younger groups, obesity was the condition most often seen in COVID-19 patients, with prevalences of 49% in 50- to 64-year-olds and 59% in those aged 18-49, Dr. Garg and associates wrote.
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Positive association between COVID-19 deaths and influenza vaccination rates in elderly people worldwide
The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is an ongoing global health crisis, directly and indirectly impacting all spheres of human life. Some pharmacological measures have been proposed to prevent COVID-19 or reduce its severity, such as vaccinations. Previous reports indicate that influenza vaccination appears to be negatively correlated with COVID-19-associated mortality, perhaps as a result of heterologous immunity or changes in innate immunity. The understanding of such trends in correlations could prevent deaths from COVID-19 in the future. The aim of this study was therefore to analyze the association between COVID-19 related deaths and influenza vaccination rate (IVR) in elderly people worldwide.
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Newborn Infected With Covid-19 In Womb Experienced Neurological Complications
Three days after birth, the baby exhibited sudden symptoms like irritability and muscle spasms, and after 11 days, the researchers observed white matter injury in the brain.
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Heart Damage in COVID-19 Patients Puzzles Doctors
Up to one in five hospitalized patients have signs of heart injury. Cardiologists are trying to learn whether the virus attacks the organ
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Coronavirus can lead to kidney damage. Why?
It's unclear exactly why the virus affects the kidneys, but doctors have several theories.
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COVID-19 and metabolic syndrome: could diet be the key?
n the current COVID-19 pandemic, governments mandate social distancing and good hand hygiene, but little attention is paid to the potential impact of diet on health outcomes. Poor diet is the most significant contributor to the burden of chronic, lifestyle-related diseases like obesity, type 2 diabetes and cardiovascular disease.1 As of 30 May 2020, the Centers for Disease Control and Prevention reported that among COVID-19 cases, the two most common underlying health conditions were cardiovascular disease (32%) and diabetes (30%).2 Hospitalisations were six times higher among patients with a reported underlying condition (45.4%) than those without reported underlying conditions (7.6%). Deaths were 12 times higher among patients with reported underlying conditions (19.5%) compared to those without reported underlying conditions (1.6%).2 Two-thirds of people in the UK who have fallen seriously ill with COVID-19 were overweight or obese and 99% of deaths in Italy have been in patients with pre-existing conditions, such as hypertension, diabetes and heart disease.3 These conditions, collectively known as metabolic syndrome, are linked to impaired immune function,4 and more severe symptoms and complications from COVID-19.5
A major factor that drives the pathophysiology of metabolic syndrome is insulin resistance,6 defined as an impaired biological response to insulin, the hormone that regulates blood glucose levels. The dysregulation of blood glucose levels plays an important role in inflammation and respiratory disease. A study of patients with COVID-19 with pre-existing type 2 diabetes showed that those with better regulated blood glucose control fared better than those with poor blood glucose control.7 Specifically, well-controlled blood glucose (glycaemic variability within 3.9–10.0 mmol/L) was associated with reduced medical interventions, major organ injuries and all-cause mortality during hospitalisation, compared with individuals with poorly controlled blood glucose (glycaemic variability exceeding 10.0 mmol/L). Another study showed hospitalised patients with hyperglycaemia treated with insulin infusion had a lower risk of death from COVID-19 than patients without insulin infusion, likely due to reduced inflammatory mediators.8
The most significant factor that determines blood glucose levels is the consumption of dietary carbohydrate, that is, refined carbs, starches and simple sugars. However, the official dietary recommendations of most Western countries advocate for a reduced (low) fat, high-carbohydrate diet, which can exaccerbate hyperglycaemia. These dietary guidelines form the basis of menus in nursing homes and hospital wards where people with COVID-19 and pre-existing metabolic syndrome are undergoing recovery and respite.
The problem is not only confined to nursing homes and hospitals. As people self-isolate at home, many are stockpiling non-perishable staple foods that are cheap such as (carbohydrate-rich) pasta, bread, rice and cereal.9 Our food supply is dominated by highly processed, packaged foods; 71% of available food in the USA is classified as ‘ultra-processed’.10 Food and beverages such as pizza, doughnuts and fruit juices and other sugary drinks are likely to drive hyperinsulinaemia and inflammation, especially in those with metabolic syndrome.
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COVID-19 and Obesity: A Clear and Present Danger in Younger Patients
Obesity confers significantly increased morbidity and mortality to younger COVID-19 patients.
In general, COVID-19 statistics point to markedly low mortality among patients younger than 60; however, 40% of the U.S. population is obese. Is the protective effect of youth negatively affected by obesity? Researchers used the American Heart Association's COVID-19 Cardiovascular Disease Registry to examine the effect of obesity across different age groups on mortality, receipt of mechanical ventilation, or both. The baseline reference group was specified as ideal body weight defined by the World Health Organization (body-mass index [BMI] 18.5–24.9 kg/m2).
Among 7606 patients, in-hospital death occurred in 1302 (17.1%) and mechanical ventilation in 1602 (21.1%). Likelihood of either event increased with BMI across class I (BMI 30.0–34.9; adjusted odds ratio, 1.3), class II (BMI 35.0–39.9; aOR, 1.6), and class III (BMI ≥40.0; aOR, 1.8) obesity. The strongest association between BMI and death or mechanical ventilation was seen in participants 50 or younger. Stage III obesity was associated with excess risk for in-hospital death in those 50 or younger (hazard ratio, 1.4), but not in those older than 50. Crude mortality rates were 3.3% (Class I), 5.0% (Class II), and 8.3% (Class III) in patients aged ≤50
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Don't Let COVID-19 Patients Die With Vitamin D Deficiency
(Richard H. Carmona, MD, MPH, was the 17th Surgeon General of the U.S. and is now a distinguished professor of public health and COVID-19 incident commander at the University of Arizona.)
The U.S. is breaking new records in the number of daily deaths from COVID-19. The breakneck speed with which several vaccines have been developed and deployed is nothing short of breathtaking. Yet we still have to confront the grim prediction that our national death toll will exceed 500,000 Americans before widespread vaccinations can dig us out of this crisis. The response to the pandemic, therefore, should include an effort to aggressively eliminate what is becoming apparent as a morbidity and mortality risk factor in COVID-19 -- vitamin D deficiency.
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Schizophrenia is a huge risk factor for COVID death – and no one can explain why
Psychiatrists from NYU found that the biggest COVID-19 death risk aside from age is schizophrenia, not one of the many common conditions that people associate with covid risks.
Schizophrenia is a more significant death risk factor in COVID-19 than diabetes, heart failure, cancer, and other more common medical conditions.
Researchers can’t explain why this particular mental disorder is such a big risk with COVID-19 and are still studying the matter.
OPINION (RJS)
Translation: the people that can't cure schitz also can't explain why these patients are so adversely affected by covid. Ignorance of the fundamental biochemistry of the disease is the reason why.
Schitz is a function of a) an oxidative body biochemistry and b) an overproduction of adrenaline.
Adrenaline suppresses the immune system.
Oxidative stress is what kills you with covid. An abnormally oxidative biochemistry is a deleterious precursor tor a poor outcome.
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