San Luis Obispo County reported 44 new cases of COVID-19 on Tuesday, bringing the county’s total to 611 confirmed cases as of June 30.
It’s the county’s largest single-day increase in cases since th…
68% of a New York clinic’s patients test positive for coronavirus antibodies – CNN
New data suggests that working-class and minority neighborhoods hit hardest by coronavirus in the borough of Queens in New York are now overwhelmingly testing positive for antibodies.
How coronavirus affects the entire body – CNN
Coronavirus damages not only the lungs, but the kidneys, liver, heart, brain and nervous system, skin and gastrointestinal tract, doctors said Friday in a review of reports about Covid-19 patients.
(CNN)Coronavirus damages not only the lungs, but the kidneys, liver, heart, brain and nervous system, skin and gastrointestinal tract, doctors said Friday in a review of reports about Covid-19 patients.
The team at the Columbia University Irving Medical Center in New York City one of the hospitals flooded with patients in the spring went through their own experiences and collected reports from other medical teams around the world.
Their comprehensive picture shows the coronavirus attacks virtually every major system in the human body, directly damaging organs and causing the blood to clot, the heart to lose its healthy rhythm, the kidneys to shed blood and protein and the skin to erupt in rashes. It causes headaches, dizziness, muscle aches, stomach pain and other symptoms along with classic respiratory symptoms like coughing and fever.
“Physicians need to think of COVID-19 as a multisystem disease,” said Dr. Aakriti Gupta, a cardiology fellow at Columbia who worked on the review, in a statement. “There’s a lot of news about clotting but it’s also important to understand that a substantial proportion of these patients suffer kidney, heart, and brain damage, and physicians need to treat those conditions along with the respiratory disease.”
Much of the damage wrought by the virus appears to come because of its affinity for a receptor a kind of molecular doorway into cells called ACE2. Cells lining the blood vessels, in the kidneys, the liver ducts, the pancreas, in the intestinal tract and lining the respiratory tract all are covered with ACE2 receptors, which the virus can use to grapple and infect cells, the Columbia team wrote in their review, published in the journal Nature Medicine.
“These findings suggest that multiple-organ injury may occur at least in part due to direct viral tissue damage,” the team wrote.
Coronavirus infection also activates the immune system. Part of that response includes the production of inflammatory proteins called cytokines. This inflammation can damage cells and organs and the so-called cytokine storm is one of the causes of severe symptoms.
“This virus is unusual and it’s hard not to take a step back and not be impressed by how many manifestations it has on the human body,” Dr. Mahesh Madhavan, another cardiology fellow who worked on the review, said in a statement,
Blood clotting effects appear to be caused by several different mechanisms: direct damage of the cells lining the blood vessels and interference with the various clotting mechanisms in the blood itself. Low blood oxygen caused by pneumonia can make the blood more likely to clot, the researchers said.
These clots can cause strokes and heart attacks or can lodge in the lungs or legs. They clog the kidneys and interfere with dialysis treatments needed for the sickest patients.
Damage to the pancreas can worsen diabetes, and patients with diabetes have been shown to be at the highest risk of severe illness and death from coronavirus.
The virus can directly damage the brain, but some of the neurological effects likely come from the treatment. “COVID-19 patients can be intubated for two to three weeks; a quarter require ventilators for 30 or more days,” Gupta said.
“These are very prolonged intubations, and patients need a lot of sedation. ‘ICU delirium’ was a well-known condition before COVID, and the hallucinations may be less an effect of the virus and more an effect of the prolonged sedation.”
The virus affects the immune system, depleting the T-cells the body usually deploys to fight off viral infections. “Lymphopenia, a marker of impaired cellular immunity, is a cardinal laboratory finding reported in 67-90% of patients with COVID-19,” the researchers wrote.
Doctors need to treat all of these effects when coronavirus patients show up in the hospital, the Columbia team said.
“Gastrointestinal symptoms may be associated with a longer duration of illness but have not been associated with increased mortality,” the researchers wrote. Many of the skin effects, such as rashes and purplish, swollen “Covid toes,” also clear up on their own.
Covid-19: What you need to know today – Hindustan Times
Delhi, based on a similar extrapolation, would then be reporting only one in 30 cases. Assuming that the actual proportion isn’t 15% but 10%, it would still be reporting only one in 20 cases. That may sound excessive, but it is probably correct.
It is likely that around 15% of Delhi’s population has already been infected by the Sars-CoV-2 virus which causes the coronavirus disease (Covid-19).
That is one of the preliminary findings of antibody tests administered to 22,823 people across all 11 districts of the Capital between June 27 and July 5. The Delhi government and the National Centre for Disease Control (NCDC), which conducted the study, are yet to publish the results.
Hindustan Times reported the preliminary findings on Friday.
Even at 15%-plus or 15%-minus (the final number may be a few percentage points higher or lower) this would suggest that there is community transmission in Delhi, though I sometimes wonder why we continue to be obsessed with this. In a press briefing by the health ministry, the first in 28 days — once, they were as regular as this column — the issue came up and the ministry once again danced around it. We should simply stop asking the ministry about this; it’s like repeatedly asking Shahid Afridi his age.
It was on the basis of antibody tests such as this that the US Centers for Disease Control and Prevention said late last month that only one in 10 cases in that country was being reported. Delhi, based on a similar extrapolation, would then be reporting only one in 30 cases. Assuming that the actual proportion isn’t 15% but 10%, it would still be reporting only one in 20 cases. That may sound excessive, but it is probably correct.
We already know many people who are infected remain asymptomatic. How many? A study by the Indian Council of Medical Research based on around 40,000 people infected by Sars-CoV-2 puts the proportion at around 28% in India. The actual proportion may be much higher — I have seen international studies with numbers ranging from 45% to 78%.
We also know that many infected people suffer mild symptoms, do not require hospitalisation, and recover, often even without any sort of medical intervention. A June study by the US CDC put the proportion of hospitalised patients at 14% of those infected (it covered 1.3 million Covid-19 patients), although this is more a measure of how many of the infected were admitted to a hospital as opposed to the number that needed to be.
Given this, it isn’t surprising that 15% of Delhi’s population may have been exposed to the virus.
On Friday, the New York Times reported, based on data from tester CityMD, which “administered 314,000 antibody tests in New York City… 26% of the tests came back positive”. In some neighbourhoods, some clinics turned in positive results as high as 56% and 68%, the report added. Both numbers are around the 60% that is widely accepted as the proportion of the population that needs to be infected for so-called herd immunity — a phenomenon where a virus or any other pathogen can’t infect too many people because it soon runs into someone who has already been infected, and is therefore immune, breaking the chain of infections.
In one particular area of Delhi, HT reported, the proportion in the early sero-survey findings was as high as 25%. Still, at 15%, Delhi is far away from 60%, or even the 43% defined in an article in Science by researchers from the universities of Stockholm and Nottingham — but the number should also be seen as 15% of Delhi’s population now being immune (we still do not know how long this immunity will last).
These people are potentially safe from a second wave, if and when one breaks, and also in a position to go out and do their thing without the fear of getting infected or passing on the infection to someone. Purely mathematically, it also means the Capital’s death rate is actually much lower (a little over 3%, based on the current numbers).
Interestingly, the 15% number is higher than the 6% a similar study in France came up with and the 5% a study from Spain (reported earlier this week in The Lancet) did. The Spanish study used the low number to highlight the difficulty of achieving herd immunity — which means this is not going to be a disease that runs out of steam in the foreseeable future, but one that needs a vaccine.
Delhi should do wider antibody testing (or sero survey, or serological study, as these are called) to better understand the real prevalence of the coronavirus disease. So should every other state. A high prevalence isn’t necessarily a bad thing.
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