Coronavirus COVID-19 - Global Health Pandemic #88

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margarita25 said:

Upon a cursory search:

Why COVID-19 is more deadly in people with obesity—even if they’re young
Sep. 8, 2020

—

CDC
Updated Dec. 1

COVID-19 and Your Health /
People with Certain Medical Conditions

“Summary of Recent Changes
Revisions were made on November 2, 2020 to reflect recent data supporting increased risk of severe illness during pregnancy from the virus that causes COVID-19. Revisions also include addition of sickle cell disease and chronic kidney disease to the conditions that might increase the risk of severe illness among children.

We are learning more about COVID-19 every day. The below list of underlying medical conditions is not exhaustive and only includes conditions with sufficient evidence to draw conclusions; it is a living document that may be updated at any time, subject to potentially rapid change as the science evolves. This list is meant to inform clinicians to help them provide the best care possible for patients, and to inform individuals as to what their level of risk may be so they can make individual decisions about illness prevention. Notably, the list may not include every condition that might increase one’s risk for developing severe illness from COVID-19, such as those for which evidence may be limited or nonexistent (e.g., rare conditions). Individuals with any underlying condition (including those conditions that are NOT on the current list) should consult with their healthcare providers about personal risk factors and circumstances to determine whether extra precautions are warranted.

Adults of any age with certain underlying medical conditions are at increased risk for severe illness from the virus that causes COVID-19. Severe illness from COVID-19 is defined as hospitalization, admission to the ICU, intubation or mechanical ventilation, or death.

Adults of any age with the following conditions are at increased risk of severe illness from the virus that causes COVID-19:

COVID-19 is a new disease. Currently there are limited data and information about the impact of many underlying medical conditions and whether they increase the risk for severe illness from COVID-19. Based on what we know at this time, adults of any age with the following conditions might be at an increased risk for severe illness from the virus that causes COVID-19:

Want to see the evidence behind these lists?

While children have been less affected by COVID-19 compared to adults, children can be infected with the virus that causes COVID-19 and some children develop severe illness. Children with underlying medical conditions are at increased risk for severe illness compared to children without underlying medical conditions. Current evidence on which underlying medical conditions in children are associated with increased risk is limited. Children with the following conditions might be at increased risk for severe illness: obesity, medical complexity, severe genetic disorders, severe neurologic disorders, inherited metabolic disorders, sickle cell disease, congenital (since birth) heart disease, diabetes, chronic kidney disease, asthma and other chronic lung disease, and immunosuppression due to malignancy or immune-weakening medications.

We do not yet know who is at increased risk for developing the rare but serious complication associated with COVID-19 in children called Multisystem Inflammatory Syndrome in Children (MIS-C), nor do we know what causes MIS-C. Learn about MIS-C.”
Click to expand...

Thanks for the info
 
ilovewings said:
This is very serious-and could be a game changer, instilling a level of fear on top of
an existing distrust of the vaccine--- how could it not show up in not one person
in the trials, and if it did show up, did they disclose that data??? did they
eliminate anyone with allergies from their trial?
Click to expand...

Have you read the 53 page submission. https://www.fda.gov/media/144245/do...jcNJUq7O1AuWTeq7dfnmqarZElvTSXsaHdDj5aLDxsiFE It starts talking about Adverse Events on page 38. What I found of interersted was the discussion of lympadenopathy (e.g. involving the axilla near the vaccine injection site) in the vaccine group (64) vs. the placebo group (6). I guess that's due to the immune response, but would love to know more. It also discuss Bell's palsy, which the FDA will recommend surveillance for cases of.

On page 40 and 48 it does discuss allergic hypersensitivity in the vaccine group (137) compared with the placebo group (111) .

"The vaccine has been shown to elicit increased local and systemic adverse reactions as compared to those in the placebo arm, usually lasting a few days. The most common solicited adverse reactions were injection site reactions (84.1%), fatigue (62.9%), headache (55.1%), muscle pain (38.3%), chills (31.9%), joint pain (23.6%), fever (14.2%). Adverse reactions characterized as reactogenicity were generally mild to moderate. The number of subjectsreporting hypersensitivity-related adverse events was numerically higher in the vaccine group compared with the placebo group (137 [0.63%] vs. 111 [0.51%]). Severe adverse reactions occurred in 0.0-4.6% of participants, were more frequent after D ose 2 than after Dose 1 and were generally less frequent in older adults (>55 years of age) (< 2.8%) as compared to younger participants (≤4.6%). Among reported unsolicited adverse events, lymphadenopathy occurred much more frequently in the vaccine group than the placebo group and is plausibly related to vaccination." from page 48
 
ilovewings said:
This is very serious-and could be a game changer, instilling a level of fear on top of
an existing distrust of the vaccine--- how could it not show up in not one person
in the trials, and if it did show up, did they disclose that data??? did they
eliminate anyone with allergies from their trial?
Click to expand...

Good question. Turns out the US excluded all people with serious allergies (as defined in the article linked above) from its trials. Did UK do the same thing? I had thought they had not, but it sounds like...really weird if on the first day 2 people get an allergic reaction.

margarita25 said:
We know that obesity (and hypertension, diabetes, which often go hand in hand with obesity) is a major factor in patients who go on to develop severe disease.

My health worker friend told me the majority of her hospitalized patients right now
are obese, and Hispanic. She said the Hispanic population is taking a beating sadly; as we already know, minority populations are getting hit the hardest.

My question is why it is exactly, medically and scientifically, that obese patients suffer more severe disease? Iirc, this is also a factor in children who develop MIS-C.
Click to expand...

The short answer is that this is a disease of severe inflammation of epithelial cells. Fat people have more cells than non-fat people (most fat people can continue to add fat cells to their existing fat cells fairly easily). We can't add other kinds of cells to our bodies. So the key thing here is indeed overall body mass index.

People with tons of muscle have been suffering too. Muscles and connective tissue have epithelial cells, etc. But, a person with more lung capacity from exercise (such as an athlete) is probably able to deal with the overall situation better.

There are other reasons, as well. Obese people are far more likely to have chronic inflammatory factors (directly due to obesity). This means that parts of their body are already inflamed. Adding explosively more inflammation (via COVID-19) is deadly to many of them. Obese people struggle harder to breathe with any pneumonia.

I need to follow that up with the fact that one family member and one friend, both obese, have survived COVID just fine (they aren't 400 pounds, but they are technically obese). The larger one actually had a nearly asymptomatic course (and she's in her 70's).

One last note on obesity: larger people need more Vitamin D and very few people are sunbathing enough to get nearly enough. So, overweight and obese people should supplement with more Vitamin D than a regular weight person. Vitamin D is now known to aid in the production of a specific protein within the immune system that inhibits COVID-19.
 
10ofRods said:
Good question. Turns out the US excluded all people with serious allergies (as defined in the article linked above) from its trials. Did UK do the same thing? I had thought they had not, but it sounds like...really weird if on the first day 2 people get an allergic reaction.



The short answer is that this is a disease of severe inflammation of epithelial cells. Fat people have more cells than non-fat people (most fat people can continue to add fat cells to their existing fat cells fairly easily). We can't add other kinds of cells to our bodies. So the key thing here is indeed overall body mass index.

People with tons of muscle have been suffering too. Muscles and connective tissue have epithelial cells, etc. But, a person with more lung capacity from exercise (such as an athlete) is probably able to deal with the overall situation better.

There are other reasons, as well. Obese people are far more likely to have chronic inflammatory factors (directly due to obesity). This means that parts of their body are already inflamed. Adding explosively more inflammation (via COVID-19) is deadly to many of them. Obese people struggle harder to breathe with any pneumonia.

I need to follow that up with the fact that one family member and one friend, both obese, have survived COVID just fine (they aren't 400 pounds, but they are technically obese). The larger one actually had a nearly asymptomatic course (and she's in her 70's).

One last note on obesity: larger people need more Vitamin D and very few people are sunbathing enough to get nearly enough. So, overweight and obese people should supplement with more Vitamin D than a regular weight person. Vitamin D is now known to aid in the production of a specific protein within the immune system that inhibits COVID-19.
Click to expand...

(Thanks, Rods. Was hoping you would “weigh in”. :) )
 
Midgie2 said:
Our youngest daughter, who is an army nurse is being deployed to Wisconsin tomorrow to work in hospital with Covid patients.
This is her second deployment this year, first one was to the Javits center N.Y.
Click to expand...

Always sent to the worst of the front lines to help out. Many blessings to her, and to all of the medical workers who are working those front lines. The US would be completely helpless at this time without them.
 

Why COVID-19 is more deadly in people with obesity—even if they’re young

“People with obesity are more likely than normal-weight people to have other diseases that are independent risk factors for severe COVID-19, including heart disease, lung disease, and diabetes. They are also prone to metabolic syndrome...”

[...]

“The physical pathologies that render people with obesity vulnerable to severe COVID-19 begin with mechanics: Fat in the abdomen pushes up on the diaphragm, causing that large muscle, which lies below the chest cavity, to impinge on the lungs and restrict airflow. This reduced lung volume leads to collapse of airways in the lower lobes of the lungs, where more blood arrives for oxygenation than in the upper lobes. “If you are already starting [with] this mismatch, you are going to get worse faster” from COVID-19, Dixon says.

Other issues compound these mechanical problems. For starters, the blood of people with obesity has an increased tendency to clot—an especially grave risk during an infection that, when severe, independently peppers the small vessels of the lungs with clots. In healthy people, “the endothelial cells that line the blood vessels are normally saying to the surrounding blood: ‘Don’t clot,’” says Beverley Hunt, a physician-scientist who’s an expert in blood clotting at Guy’s and St. Thomas’ hospitals in London. But “we think that signaling is being changed by COVID,” Hunt says, because the virus injures endothelial cells, which respond to the insult by activating the coagulation system.

Add obesity to the mix, and the clotting risk shoots up. In COVID-19 patients with obesity, Hunt says, “You’ve got such sticky blood, oh my—the stickiest blood I have ever seen in all my years of practice.””
 
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I'm so incredibly sick of the ignorance, selfishness and greed of people this year.

Thank goodness for the sanity I find here on Websleuths.

PS: I do not want to stir up any crazy vaccine debates, but here is a report of the outcome for one unvaccinated child who developed a vaccine preventable illness (perhaps there are families in the Chatham, NY area who should take note ;-) ).
Notes from the Field: Tetanus in an Unvaccinated Child — Oregon, ...
 
More about obesity and covid wrt immunity specifically:

“Immunity also weakens in people with obesity, in part because fat cells infiltrate the organs where immune cells are produced and stored, such as the spleen, bone marrow, and thymus, says Catherine Andersen, a nutritional scientist at Fairfield University. “We are losing immune tissue in exchange for adipose tissue, making the immune system less effective in either protecting the body from pathogens or responding to a vaccine,” she says.

The problem is not only fewer immune cells, but less effective ones, adds Melinda Beck, a co-author of the Obesity Reviews metaanalysis who studies obesity and immunity at the University of North Carolina, Chapel Hill. Beck’s studies of how obese mice respond to the influenza virus demonstrated that key immune cells called T cells “don’t function as well in the obese state,” she says. They make fewer molecules that help destroy virus-infected cells, and the corps of “memory” T-cells left behind after an infection, which is key to neutralizing future attacks by the same virus, is smaller than in healthy weight mice.

Beck’s work suggests the same thing happens in people: She found that people with obesity vaccinated against flu had twice the risk of catching it as vaccinated, healthy weight people. That means trials of vaccines for SARS-CoV-2 need to include people with obesity, she says, because “coronavirus vaccines may be less effective in those people.”

Beyond an impaired response to infections, people with obesity also suffer from chronic, low-grade inflammation. Fat cells secrete several inflammation-triggering chemical messengers called cytokines, and more come from immune cells called macrophages that sweep in to clean up dead and dying fat cells. Those effects may compound the runaway cytokine activity that characterizes severe COVID-19. “You end up causing a lot of tissue damage, recruiting too many immune cells, destroying healthy bystander cells,” says Ilhem Messaoudi, an immunologist who studies host responses to viral infection at the University of California, Irvine. Of the added risk from obesity, she adds: “I would say a lot of it is immune-mediated.”“

Why COVID-19 is more deadly in people with obesity—even if they’re young
 
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3 new videos on vaccine and allergies:

Dr. Fauci Warns Those With Underlying Allergic Tendencies Prone To Covid Vaccine Reactions


Note she says to wait, no matter what type of allergy “trigger“ you have
 
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I cried with her. So sad and upsetting. I feel scared and feel betrayed. We needed to be better protected. :(:(:(

L.A. County public health director breaks down in tears while describing ‘incalculable’ COVID-19 deaths | KTLA

Los Angeles County’s top health officer broke down in tears Wednesday as she spoke about the devastating toll the COVID-19 surge has had on the region during a briefing on the pandemic.

“Over 8,000 people who are beloved members of their families are not coming back and their deaths are an incalculable loss to their friends and family as well as to our community,” Barbara Ferrer, the county’s public health director, said as she struggled to gain composure.
...
 
margarita25 said:
Upon a cursory search:

Why COVID-19 is more deadly in people with obesity—even if they’re young
Sept. 8, 2020

—

CDC / COVID-19 and Your Health /People with Certain Medical Conditions
Updated Dec. 1, 2020

“Summary of Recent Changes
Revisions were made on November 2, 2020 to reflect recent data supporting increased risk of severe illness during pregnancy from the virus that causes COVID-19. Revisions also include addition of sickle cell disease and chronic kidney disease to the conditions that might increase the risk of severe illness among children.

We are learning more about COVID-19 every day. The below list of underlying medical conditions is not exhaustive and only includes conditions with sufficient evidence to draw conclusions; it is a living document that may be updated at any time, subject to potentially rapid change as the science evolves. This list is meant to inform clinicians to help them provide the best care possible for patients, and to inform individuals as to what their level of risk may be so they can make individual decisions about illness prevention. Notably, the list may not include every condition that might increase one’s risk for developing severe illness from COVID-19, such as those for which evidence may be limited or nonexistent (e.g., rare conditions). Individuals with any underlying condition (including those conditions that are NOT on the current list) should consult with their healthcare providers about personal risk factors and circumstances to determine whether extra precautions are warranted.

Adults of any age with certain underlying medical conditions are at increased risk for severe illness from the virus that causes COVID-19. Severe illness from COVID-19 is defined as hospitalization, admission to the ICU, intubation or mechanical ventilation, or death.

Adults of any age with the following conditions are at increased risk of severe illness from the virus that causes COVID-19:

COVID-19 is a new disease. Currently there are limited data and information about the impact of many underlying medical conditions and whether they increase the risk for severe illness from COVID-19. Based on what we know at this time, adults of any age with the following conditions might be at an increased risk for severe illness from the virus that causes COVID-19:

Want to see the evidence behind these lists?

While children have been less affected by COVID-19 compared to adults, children can be infected with the virus that causes COVID-19 and some children develop severe illness. Children with underlying medical conditions are at increased risk for severe illness compared to children without underlying medical conditions. Current evidence on which underlying medical conditions in children are associated with increased risk is limited. Children with the following conditions might be at increased risk for severe illness: obesity, medical complexity, severe genetic disorders, severe neurologic disorders, inherited metabolic disorders, sickle cell disease, congenital (since birth) heart disease, diabetes, chronic kidney disease, asthma and other chronic lung disease, and immunosuppression due to malignancy or immune-weakening medications.

We do not yet know who is at increased risk for developing the rare but serious complication associated with COVID-19 in children called Multisystem Inflammatory Syndrome in Children (MIS-C), nor do we know what causes MIS-C. Learn about MIS-C.”
Click to expand...
1st child in L.A. County dies from rare inflammatory syndrome linked to coronavirus | KTLA
...
The patient, who was at Children’s Hospital Los Angeles, had a “complex, preexisting cardiac condition” and died from complications tied to MIS-C, public relations officer Lauren Song said in a statement Wednesday.
...
 
pocketaccent said:
1st child in L.A. County dies from rare inflammatory syndrome linked to coronavirus | KTLA
...
The patient, who was at Children’s Hospital Los Angeles, had a “complex, preexisting cardiac condition” and died from complications tied to MIS-C, public relations officer Lauren Song said in a statement Wednesday.
...
Click to expand...

Just couldn't bring myself to click "like" on this one - but wanted to say thank you for posting. So many people are vulnerable. It's like we're throwing them to the wolves.
 
CrimeAway said:
I'm so incredibly sick of the ignorance, selfishness and greed of people this year.

Thank goodness for the sanity I find here on Websleuths.

PS: I do not want to stir up any crazy vaccine debates, but here is a report of the outcome for one unvaccinated child who developed a vaccine preventable illness (perhaps there are families in the Chatham, NY area who should take note ;-) ).
Notes from the Field: Tetanus in an Unvaccinated Child — Oregon, ...
Click to expand...

Poor little guy with tetanus! What a horrible ordeal he went through. And this...

The boy required 57 days of inpatient acute care, including 47 days in the intensive care unit. The inpatient charges totaled $811,929 (excluding air transportation, inpatient rehabilitation, and ambulatory follow-up costs). One month after inpatient rehabilitation, he returned to all normal activities, including running and bicycling. Despite extensive review of the risks and benefits of tetanus vaccination by physicians, the family declined the second dose of DTaP and any other recommended immunizations.

Notes from the Field: Tetanus in an Unvaccinated Child — Oregon, ...

I hope they had insurance. And now I will sit on my hands. :mad:
 
Infected after 5 minutes, from 20 feet away: South Korea study shows coronavirus' spread indoors
SEOUL — Dr. Lee Ju-hyung has largely avoided restaurants in recent months, but on the few occasions he’s dined out, he’s developed a strange, if sensible, habit: whipping out a small anemometer to check the airflow.

It’s a precaution he has been taking since a June experiment when he and colleagues recreated the conditions at a restaurant in Jeonju, a city in the southwest of South Korea, where diners contracted COVID-19 from an out-of-town visitor. Among them was a high school student who was infected with the coronavirus after five minutes of exposure from more than 20 feet away.
...
Linsey Marr, a civil and environmental engineering professor at Virginia Tech who studies the transmission of viruses in the air, said the five-minute window in which the student, identified in the study as “A,” was infected was notable because the droplet was large enough to carry a viral load, but small enough to travel 20 feet through the air.
...
Lee and his team recreated the conditions in the restaurant — researchers sat at tables as stand-ins — and measured the airflow. The high school student and a third diner who was infected had been sitting directly along the flow of air from an air conditioner; other diners who had their back to the airflow were not infected. Through genome sequencing, the team confirmed the three patients’ virus genomic types matched.

“Incredibly, despite sitting a far distance away, the airflow came down the wall and created a valley of wind. People who were along that line were infected,” Lee said. “We concluded this was a droplet transmission, and beyond two meters.”
...

“Eating indoors at a restaurant is one of the riskiest things you can do in a pandemic,” she said. “Even if there is distancing, as this shows and other studies show, the distancing is not enough.”
90
 
SoCalDavidS said:
In the coming months, I am looking forward to reading as Websleuths posters report that they received the Vaccine.

Perhaps there should be a Thread Dedicated to allowing people to simply post that they got Vaccinated, along with any complications or side effects experienced and/or the brand of vaccine it was.
Click to expand...

Mods/Admins are currently reviewing this and may have something set up soon.
 
Lilibet said:
Poor little guy with tetanus! What a horrible ordeal he went through. And this...

The boy required 57 days of inpatient acute care, including 47 days in the intensive care unit. The inpatient charges totaled $811,929 (excluding air transportation, inpatient rehabilitation, and ambulatory follow-up costs). One month after inpatient rehabilitation, he returned to all normal activities, including running and bicycling. Despite extensive review of the risks and benefits of tetanus vaccination by physicians, the family declined the second dose of DTaP and any other recommended immunizations.

Notes from the Field: Tetanus in an Unvaccinated Child — Oregon, ...

I hope they had insurance. And now I will sit on my hands. :mad:
Click to expand...

I'm going to bet that even with insurance, that's an incredibly hefty bill (the dark side of illness in the US that many COVID deniers will face in future - even a short hospital stay is expensive).

For example, most people have a deductible (which can be as large as $20,000 for the family). For those of us with really good insurance, it can still be $2000-5000. Then, in my case, I have to pay 20% of the remainder (unless I'm in network - which my care, right now, actually is - but not everyone has that worked out).

The air transport, etc, will add a lot to their bill as well. And the child is still vulnerable to tetanus, lifelong. As well as whooping cough and diphtheria.
 
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