Breakthrough infections can lead to long COVID; genes may explain critical illness in young, healthy adults

By Nancy Lapid

(Reuters) – The following is a summary of some recent studies on COVID-19. They include research that warrants further study to corroborate the findings and that have yet to be certified by peer review.

Breakthrough infections can lead to long COVID

The persistent syndrome of COVID-19 after-effects known as long COVID can develop after “breakthrough” infections in vaccinated people, a new study shows. Researchers at Oxford University in the UK reviewed data on nearly 20,000 U.S. COVID-19 patients, half of whom had been vaccinated. Compared to unvaccinated patients, people who were fully vaccinated – and in particular those under age 60 – did have lower risks for death and serious complications such as lung failure, need for mechanical ventilation, ICU admission, life-threatening blood clots, seizures, and psychosis. “On the other hand,” the research team reported on medRxiv on Thursday ahead of peer review, “previous vaccination does not appear to protect against several previously documented outcomes of COVID-19 such as long COVID features, arrhythmia, joint pain, Type 2 diabetes, liver disease, sleep disorders, and mood and anxiety disorders.” The absence of protection from long COVID “is concerning given the high incidence and burden” of these lasting problems, they added.

Genes may explain critical COVID-19 in young, healthy adults

A gene that helps the coronavirus reproduce itself might contribute to life-threatening COVID-19 in young, otherwise healthy people, new findings suggest. French researchers studied 72 hospitalized COVID-19 patients under age 50, including 47 who were critically ill and 25 with non-critical illness, plus 22 healthy volunteers. None of the patients had any of the chronic conditions known to increase the risk for poor outcomes, such as heart disease or diabetes. Genetic analysis identified five genes that were significantly “upregulated,” or more active, in the patients with critical illness, of which the most frequent was a gene called ADAM9. As reported on Thursday in Science Translational Medicine, the researchers saw the same genetic pattern in a separate group of 154 COVID-19 patients, including 81 who were critically ill. Later, in lab experiments using human lung cells infected with the coronavirus, they found that blocking the activity of the ADAM9 gene made it harder for the virus to make copies of itself. More research is needed, they say, to confirm their findings and to determine whether it would be worthwhile to develop treatments to block ADAM9.

Pregnant women get sub-par benefit from first vaccine dose

Women who get the first dose of an mRNA COVID-19 vaccine while pregnant or breastfeeding need the second dose to bring their protective benefit up to normal, according to a new study. Researchers compared immune responses to the mRNA vaccines from Moderna Inc or Pfizer Inc and partner BioNTech SE in 84 pregnant women, 31 breastfeeding women, and 16 similarly-aged nonpregnant, non-lactating women. After the first shot, everyone developed antibodies against the coronavirus. But antibody levels were lower in women who were pregnant or breastfeeding. Other features of the immune response also lagged in the pregnant and lactating women after the first dose but “caught up” to normal after the second shot. In a report published on Thursday in Science Translational Medicine, the researchers explained that in order for a mother’s body to nurture the fetus, “substantial immunological changes occur throughout pregnancy.” The new findings suggest that pregnancy alters the immune system’s response to the vaccine. Given that pregnant women are highly vulnerable to complications from COVID-19, “there is a critical need” for them to get the second dose on schedule, the researchers said.

Coronavirus found to infect fat cells

Obesity is a known risk factor for more severe COVID-19. One likely reason may be that the virus can infect fat cells, researchers have discovered. In lab experiments and in autopsies of patients who died of COVID-19, they found the virus infects two types of cells found in fat tissue: mature fat cells, called adipocytes, and immune cells called macrophages. “Infection of fat cells led to a marked inflammatory response, consistent with the type of immune response that is seen in severe cases of COVID-19,” said Dr. Catherine Blish of Stanford University School of Medicine, whose team reported the findings on bioRxiv on Wednesday ahead of peer review. “These data suggest that infection of fat tissue and its associated inflammatory response may be one of the reasons why obese individuals do so poorly when infected with SARS-CoV-2,” she said.

(Reporting by Nancy Lapid; Editing by Bill Berkrot)

Delayed 2nd Pfizer/BioNTech shot boosts antibodies in elderly; COVID-19 obesity risk higher for men

By Nancy Lapid

(Reuters) – The following is a roundup of some of the latest scientific studies on the novel coronavirus and efforts to find treatments and vaccines for COVID-19, the illness caused by the virus.

Delaying second Pfizer/BioNTech dose boosts antibodies in elderly

Delaying the second dose of the Pfizer/BioNTech COVID-19 vaccine beyond the originally recommended three-week gap used by the companies in clinical trials appears to induce a stronger antibody response in the elderly, UK researchers found. Shortly after the vaccine became available, UK health officials advised that the second dose should be given 12 weeks after the first to allow more people to get protected by a first dose early on. In a new paper seen by Reuters and expected to appear on medRxiv on Friday ahead of peer review, researchers found that among 175 people ages 80 to 99, those who got their second dose at 12 weeks had antibody responses that were 3.5 times higher than those who got it after three weeks. Antibodies are only one part of the immune system, and vaccines also generate T cells that fight infections. The peak T cell responses were higher in the group with a three-week interval between doses, and the authors cautioned against drawing conclusions on how protected individuals were based on which dosing schedule they received.

Impact of obesity on COVID-19 risks may be greater in men

The known increased risk of severe COVID-19 and death linked to obesity may be even more pronounced for men than women, new data suggest. Researchers studied 3,530 hospitalized COVID-19 patients with an average age of 65, including 1,469 who were obese. In men, moderate obesity was associated with a significantly higher risk of developing severe disease, needing mechanical breathing assistance and dying from COVID-19. (The threshold for moderate obesity is a body mass index (BMI) of 35. In an 5-foot, five-inch tall (1.65 m) adult, that would correspond to a weight of 210 pounds (95 kg). In women, however, only a BMI of 40 or higher, indicating severe obesity, was linked with the increased risks. In a report published in European Journal of Clinical Microbiology & Infectious Diseases, the researchers note that while obesity is known to be linked with body-wide inflammation, patients’ levels of inflammatory proteins did not appear to explain the association between obesity and severe illness. For now, they conclude, “particular attention should be paid” to protecting patients with obesity from the coronavirus, “with priority to vaccination access, remote work, telemedicine, and other measures given the higher risk of adverse outcomes once they are diagnosed with COVID-19.”

COVID-19 testing rates low among symptomatic Americans

Sick Americans appear to be passing up opportunities to get tested for coronavirus and thus are likely unknowingly spreading the infection throughout their communities, new research shows. Among 37,000 adults across the United States who participated in a smartphone app survey between March and October 2020, nearly 2,700 reported at least one episode of fever and chills. But according to a report published in JAMA Network Open, only a small fraction reported receiving a COVID-19 test result within seven days of the onset of illness. At first, as tests became more accessible, the numbers improved. In early April 2020, less than 10% of survey participants reporting illness with fever received test results within a week. By late July, that proportion had increased to 24.1%. Throughout the summer and fall, as tests became easier to find, the number of sick participants who reported getting tested remained flat. By late October, only 26% reported receiving a test result within a week of febrile illness. “It’s shocking to me that when people have a fever they’re still not getting tested,” said coauthor Dr. Mark Pletcher of the University of California, San Francisco. “Tests are easy to come by. People might have coronavirus, might be spreading it to their friends and neighbors, and they’re not getting tested.”

(Reporting by Nancy Lapid, Alistair Smout and Ronnie Cohen; Editing by Bill Berkrot)

Why is New Orleans’ coronavirus death rate nearly three times New York’s? Obesity is a factor

By Brad Brooks

(Reuters) – The coronavirus has been a far deadlier threat in New Orleans than the rest of the United States, with a per-capita death rate almost three times that of New York City. Doctors, public health officials and available data say the Big Easy’s high levels of obesity and related ailments may be part of the problem.

“We’re just sicker,” said Rebekah Gee, who until January was the health secretary for Louisiana and now heads Louisiana State University’s healthcare services division. “We already had tremendous healthcare disparities before this pandemic – one can only imagine they are being amplified now.”

Along with New York and Seattle, New Orleans has emerged as one of the early U.S. hot spots for the coronavirus, making it a national test case for how to control and treat the disease it causes. Chief among the concerns raised by doctors working in the Louisiana city is the death rate, which is close to three times that of New York and over four times that of Seattle, based on publicly reported data.

New Orleans residents suffer from obesity, diabetes and hypertension at rates higher than the national average, conditions that doctors and public health officials say can make patients more vulnerable to COVID-19, the highly contagious respiratory disease caused by the coronavirus.

Some 97% of those killed by COVID-19 in Louisiana had a pre-existing condition, according to the state health department. Diabetes was seen in 40% of the deaths, obesity in 25%, chronic kidney disease in 23% and cardiac problems in 21%.

Orleans Parish, which encompasses the city, reported 115 deaths as of Wednesday, giving it 29.5 coronavirus deaths per 100,000 people. That rate for New York City was at 10.8 on Wednesday.

New Orleans could be a harbinger for the potential toll the pandemic could take in other parts of the South and Midwest that also have high rates of obesity, diabetes, and hypertension.

A host of other factors could contribute to New Orleans’ high death rate from COVID-19, ranging from access to healthcare and hospital quality, to the prevalence of other conditions, including lung disease, health officials say.

But they also note that it is clear that obesity-related conditions are playing a role in the deaths. That could be a warning sign for the United States at large, where chronic obesity is more common than in other developed countries, they said.

Hospitals are reporting cases across the generations -mothers and daughters, fathers and sons – being intubated and cared for in the same intensive care units, said Tracey Moffatt, the chief nursing officer at Ochsner Health, the largest healthcare provider in Louisiana. The prevalence of obesity, diabetes, hypertension and heart disease in New Orleans and Louisiana plays into that, she said.

Those family members often suffered from the same medical conditions before becoming sick, leaving them similarly vulnerable to the coronavirus despite their age gaps.

“We had a case where a mom was already in the ICU and the daughter, who was obese, came in,” she said. “The daughter asked staff to wheel her by her mom’s room so she could say goodbye before she herself was intubated. We knew the mother was going to pass away.”

Both patients suffered from obesity.


The Centers for Disease Control and Prevention this week released for the first time a report showing that 78% of COVID-19 patients in ICUs in the United States had an underlying health condition, including diabetes, cardiovascular disease and chronic lung disease.

The CDC report was based on a sample of under 6% of reported coronavirus infections, but doctors in Louisiana said it was consistent with what they are seeing, and it is in line with what other countries like Italy and China have faced.

Those percentages, said Dr. Joseph Kanter, an emergency department doctor and the top public health official in New Orleans, are likely similar in cities across the United States.

“What we worry about here is that we have more people in our communities with those conditions,” he said. “We’re more vulnerable than other communities, and the number of deaths we’ve seen illustrates that.”

The New Orleans metropolitan statistical area ranks among the worst in the United States for the percentage of residents with diabetes, high blood pressure and obesity, a Reuters analysis of CDC data shows. An estimated 39% have high blood pressure, 36% are obese and about 15% have diabetes.

Nationally, the median is 32% with high blood pressure, 31% obese and 11% with diabetes.

“The burden of disease in Louisiana and the Deep South is higher than in the rest of the country,” said Gee. “Invariably that means that the South is going to be hard hit by this.”

(This story corrects headline, paragraphs 1 and 3 to reflect actual death toll of Orleans Parish of 115 deaths; Inserts new paragraph 6 with breakdown of figures.)

(Reporting by Brad Brooks in Austin, Texas, additional reporting by Ryan McNeill in London; Editing by Scott Malone, Rosalba O’Brien and Dan Grebler)

Latin America to tackle dual problems of hunger and obesity

BOGOTA (Thomson Reuters Foundation) – Latin American governments have pledged to work toward ending hunger within a decade while tackling an epidemic of rising obesity in the region – itself considered a form of malnutrition.

At a regional meeting of the U.N. Food and Agriculture Organisation (FAO), government representatives from across Latin American and the Caribbean drew up plans to accelerate cuts in hunger, which has halved in the region in the last 25 years.

At the same time, far more attention needs to be paid to combating obesity, particularly among women, in a region where nearly a quarter of all adults are obese, the FAO said.

“Countries have been very clear: the regional priority is to eradicate hunger by 2025,” Jose Graziano da Silva, head of the FAO said at the meeting in Mexico City which ended on Thursday.

Efforts to combat hunger will focus on Central America’s “dry corridor” running through Guatemala, El Salvador and Honduras, where millions of people have been affected by a prolonged drought exacerbated by climate change.

“Today, climate change has caused those droughts to be more erratic, prolonged and unpredictable,” Graziano da Silva said.

He said Latin America and the Caribbean can be the first region to achieve two of the U.N.’s Sustainable Development Goals – eradicating hunger and poverty – five years before the proposed target dates of 2030.

Since 1991, the number of hungry people in Latin America and the Caribbean has halved to 34 million from 66 million and the region was the only one that met the U.N. Millennium Development Goals on reducing hunger by 2015, the FAO says.

Aid in the form of conditional cash transfers targeting poor families, pioneered by some of the region’s biggest economies, including Brazil, have meant people have had more money to spend on food.

But changing diets have triggered a rising tide of obesity, with nearly a third of women and four million children now obese in the region.

Programmes aimed at making it easier for family farmers to access credit, insurance, seeds and fertilizers, to encourage them to grow traditional food crops are one way of addressing the problem, Graziano da Silva said.

“The rescue of the region’s traditional crops and food products will allow to promote better diets and face the double burden of malnutrition,” he said.

Initiatives that encourage local governments to buy produce directly from farmers to provide healthy food for school meals, already well-established and hailed as a success in Brazil, will be promoted across Latin America, the FAO said.

The agency said more needs to be done to help subsistence farmers adjust to the impact of climate change, which brings increasing extreme and erratic weather from drought to flooding.

Latin America’s agricultural sector lost $11 billion due to natural disasters between 2003 and 2013, the FAO said.

Efforts must also focus on sustainable fishing by states signing an International Agreement on Port State Measures, which seeks to combat illegal fishing. Three more countries need to ratify the agreement for it to come into effect, the FAO said.

(Reporting by Anastasia Moloney, editing by Ros Russell)

Study Says Obese People Cannot Be Healthy

A new study shows that being obese increases the risk of death calling into question the idea that someone can be obese and still be considered “healthy.”

The study showed people who were obese but did not have a metabolic problem such as high blood pressure or cholesterol problems were still 24% more likely to experience heart problems over a 10-year time frame when compared to people of normal weight.

The researchers from Mount Sinai Hospital in Toronto declared “there is no ‘healthy’ pattern of obesity.”

Dr. Holly Wyatt of the University of Colorado said the findings are consistent with the idea that obesity itself is a disease. The American Medical Association first agreed with the idea earlier this year.

Critics accused the study researchers of misinterpreting their results.

Obesity Could Pose Osteoporosis Risk

A new study suggests that obesity is a contributing factor to the frail bone disease osteoporosis.

A Harvard Medical School study on 106 men and women in the Boston area showed hidden fat inside their bones that could lead to fractures. Body scans of the overweight but otherwise healthy patients showed fat hidden in the liver, muscles and bone marrow along with belly, hips or thighs. Continue reading

Wasted Years

One of the last times my father walked without assistance was when he walked me down the aisle.  He had developed diabetes because of his weight problem, and was now suffering complications from the disease.  Although he was in a lot of pain, Dad was determined to give me away. “Little Girl, this is the proudest moment of my life,” he told me.

In November 1999 Jim and I spent a week with Dad and Lita in Phoenix.  Jim had quizzed the doctor when we took my dad for an appointment that week.  The doctor had said that because of the complications from diabetes, they would likely have to amputate one of Dad’s legs within a year.  “But he’s a strong man,” the doctor said, “and he could live another five years, especially if he would take care of himself.”

On Monday afternoon Jim and I left Phoenix. We were getting in the car to drive to the airport when I turned around and went back in the house to hug Dad again. He held me to his chest and said, “Little Girl, don’t ever forget. Your daddy loves you.” Those were his last words to me.

The next morning Jim and Tammy Sue sat me down and broke the news that my dad had just passed away. Sue knelt down beside me and tenderly held my hand while Jim stood behind me and put his arms around me. They surrounded me with love in that difficult moment.

Peace filled my heart, and I felt that God was saying to me, your dad’s with me here now, and he is happy.

I had needed to know that my dad was in heaven.  God knew dad’s heart. And I believe my dad had finally come to understand the gift of God’s grace.

But he left this world many years before he needed to – because he could not control his eating.  He literally ate himself to death.  His refusal to take better care of himself deprived him and our entire family of many years together.

The wisdom of healthy living is beyond measurable.

Take care of yourself and do what you can to live out your appointed years.  Your family needs you and it is not God’s plan for you to waste the years He has appointed unto you.