Coronavirus Briefing Newsletter – Times of India

• India on Sunday reported 343 Covid cases and 4 fatalities. The cumulative caseload is 4,46,71,562 (5,263 active cases) and 5,30,612 fatalities
• Worldwide: Over 641 million cases and over 6.63 million fatalities.
• Vaccination in India: Over 2.19 billion doses. Worldwide: Over 12.86 billion doses.

A concern

• Children are at increased risk of stroke following Covid-19, according to a study published in the journal Pediatric Neurology. The researchers found the overall number of strokes significantly higher than what had been seen historically at Intermountain Primary Children’s Hospital.
• The study also showed that the risk of stroke is independent of whether or not the patient has Multisystem Inflammatory Syndrome in Children (MIS-C), a known complication of Covid-19.
• Data show that even kids who had asymptomatic Covid-19 could develop a serious complication like stroke, said MaryGlen J Vielleux, a paediatric neurology resident at University of Utah Health and lead author of the study.

However…

• The findings of this study are in contrast to the findings of a 2021 international study of children early in the pandemic. That study suggested that Covid-19 did not cause an increased risk of stroke in children.

The study

• It was a retrospective, population-based cohort analysis, conducted between March 1, 2020, and June 30, 2021 at a children’s hospital. Paediatric patients with a diagnosis of ischemic stroke were identified using ICD-10 diagnosis of ischemic stroke, cerebrovascular accident, or cerebral infarction.
• Most of those strokes took place between February and May 2021, shortly after the surge of Covid-19 paediatric cases. Of those tested for Covid-19 antibodies, nearly half tested positive.

How do they know it?

• The research reviewed medical charts and diagnosis codes to identify 16 hospital patients who had an ischemic stroke between March 2020 and June 2021.
• Sixteen patients, seven male and nine female, with ischemic stroke were in focus. None of them had been severely sick with the virus and some had been asymptomatic, the researchers said. Five patients were not tested for past Covid illnesses, which is a limitation of the study, they said.
• “It may be that hyper-immune response that comes later that’s causing kids to clot,” said Vielleux.
• In the first six months of 2021, the hospital cared for 13 kids with a stroke of unknown origins.

Yes, a bad news

• Those with post-traumatic stress disorder (PTSD) or other mental illnesses faced substantially higher risk of hospitalisation or even death from Covid-19 compared to the general population, finds a new study focusing on US veterans.

The study

• Researchers from UC San Francisco and the San Francisco VA Health Care System tracked data from more than a quarter a million veterans who tested positive between February 2020 and August 2021, with most cases occurring prior to getting vaccinated.
• The average age of those in the study was 60.6 years — 89.5% men, and 72.1% with at least one other medical condition, such as obesity, diabetes and heart disease.

The findings

• The researchers found that veterans with PTSD had an 8% increased risk of death if they had Covid-19 and a 9% higher risk of hospitalisation, compared with patients with the virus and without a psychiatric diagnosis, adjusting for age, sex, race and co-occurring medical conditions.
• “Psychological stress from the pandemic overall, or the experience of SARS-CoV-2 infection itself, may have exacerbated psychiatric symptoms, which could affect inflammatory response,” says Aoife O’Donovan, a senior author of the study.
• “Additionally, PTSD may accelerate cellular ageing, shortening telomeres, thus increasing the risk of age-associated diseases.”
• Those with psychosis similarly had a 58% increased risk of death and a 66% increased risk of hospitalisation, adds the study published in Translational Psychiatry.
• For those with bipolar disorder the increased risks were pegged at 29% and 46%, respectively, and for major depression, the corresponding figures were 13% and 21%, respectively.

And, more

• Researchers also found that patients with substance or alcohol use disorder were significantly more likely to be hospitalised for Covid: 62% and 45%, respectively.
• Mortality rates among those with substance or alcohol use were about the same as those without a psychiatric diagnosis, indicating that lack of caregiver or social support, and an increased incidence of homelessness may be driving these higher hospitalisation rates.

Two studies published recently show that despite people giving up the use of face masks, thinking that the Covid-19 pandemic is over, or not sending their kids with their faces masked, assuming that Covid-19 is mild among kids, may be completely wrong. The studies indicate that masking helps prevent not only Covid-19 but also other respiratory illnesses.

Masks protect kids

• A study, published in The New England Journal of Medicine, found that masking mandates were linked with significantly reduced numbers of Covid-19 cases in schools in the US. The researchers from the Harvard TH Chan School of Public Health studied Covid-19 incidences in schools where masking was mandatory and compared with those that lifted the restrictions over 15 weeks.
• The study provides new evidence that the removal of universal school masking policies in Massachusetts was associated with an increased incidence of Covid-19.
• The researchers concluded that removing mask mandates led to an additional rise of 44.9 Covid-19 cases per 1,000 students and staff members, corresponding to an estimated 11,901 cases during the 15-week period.
• “We saw sustained, increased rates of COVID incidence consistently in schools that lifted the mask requirement,” Tori L Cowger, the study’s first author, was quoted as saying by the New York Times.
• “This study shows that if people are wearing masks as a group, that it reduces transmission for everyone in the population, and it reduces school absences and teacher absences,” said Julia Raifman, co-author of the study.

Masks and asthma

• Another study, published in the journal Thorax, found an increased risk of asthma attacks among adults after the pandemic restrictions were lifted.
• It said when restrictions were lifted, fewer people wore face coverings and there was more social mixing, and subsequently a higher risk of Covid-19 and other acute respiratory infections.
• The research also showed that Covid-19 was not significantly more likely to trigger asthma attacks than other respiratory infections.
• In April 2021, when social mixing restrictions and the need for face coverings started to be relaxed, 1.7% participants reported having a severe asthma attack in the previous month. But in January 2022, this proportion more than doubled, going up to 3.7 per cent.
• Martineau, lead author of the research, said the findings do raise the possibility that certain elements of the public health measures introduced during the pandemic — including wearing face masks — could help in reducing respiratory illnesses moving forward.