The Percentage Of COVID Patients With No Symptoms

The surprising proportion of infected people with the COVID-19 virus who show no symptoms.

The surprising proportion of infected people with the COVID-19 virus who show no symptoms.

A remarkable number of coronavirus patients have no symptoms of the disease at all.

Analysis of public datasets by the Scripps Research team suggest that nearly 45 percent of people carrying SARS-CoV-2 are asymptomatic.

An asymptomatic person does not show any symptoms of infection but is able to pass the virus to others for more than two weeks.

The very high percentage of asymptomatic cases most likely played a key part in the early stages of the coronavirus disease pandemic by spreading the virus silently and vigorously.

Hence, the research points out the necessity for extensive testing and contact tracing in order to reduce the spread of Covid-19 in populations.

Professor Eric Topol, the director of the Scripps Research Translational Institute, said:

“The silent spread of the virus makes it all the more challenging to control.

Our review really highlights the importance of testing.

It’s clear that with such a high asymptomatic rate, we need to cast a very wide net, otherwise the virus will continue to evade us.”

Professor Topol and his colleague gathered this data from 16 studies worldwide.

The data also includes cruise ship passengers, nursing home residents, prison inmates, among others.

Mr Daniel Oran, study’s first author, said:

“What virtually all of them had in common was that a very large proportion of infected individuals had no symptoms.

Among more than 3,000 prison inmates in four states who tested positive for the coronavirus, the figure was astronomical: 96 percent asymptomatic.”

When the team reviewed the collected information, they noticed that asymptomatic people can spread the virus for an extended time, possibly lasting beyond 14 days.

Viral load is the amount of virus present in an infected person and generally higher viral loads lead to worse outcomes.

The study found that the SARS-CoV-2 viral load in asymptomatic persons was at the same level as symptomatic patients, therefore the chance of viral transmission could be similar.

Also, just because they don’t carry any symptoms, it does not mean that there won’t be any harm.

For example, CT scans on asymptomatic patients of the Diamond Princess cruise ship show subclinical abnormalities in the lungs.

This is probably due to the impact of the SARS-CoV-2 infection on lung function despite not showing immediately.

The authors, however, admit that it is difficult to differentiate between pre-symptomatic and asymptomatic patients since long-term data and repeated testing are not available.

A pre-symptomatic individual is a person who has been infected with the virus and will sooner or later show symptoms, whereas an asymptomatic person will have silent symptoms of COVID-19 even though they are similarly infected.

Mr Oran said:

“Our estimate of 40 to 45 percent asymptomatic means that, if you’re unlucky enough to get infected, the probability is almost a flip of a coin on whether you’re going to have symptoms.”

The study was published in Annals of Internal Medicine (Oran & Topol , 2020).

A New Therapy Using Human Antibodies Could Prevent COVID-19

A potent vaccine-like treatment against Covid-19 could swiftly protect new patients.

A potent vaccine-like treatment against Covid-19 could swiftly protect new patients.

Powerful antibodies found in the blood of coronavirus survivors could protect patients who are in the early stage of infection.

Injection of monoclonal antibodies (mAbs) is a potential treatment against SARS-CoV-2 infection.

The treatment gives a vaccine-like protection which suppresses the severity of illness and stays long enough in patients’ blood to help the immune system getting rid of antigens.

A team from Scripps Research identified potent antibodies against the virus in patients recovered from COVID-19.

The therapy could potentially prevent the COVID-19 disease and now it is set for clinical trials.

Dr Dennis Burton, study co-author, said:

“The discovery of these very potent antibodies represents an extremely rapid response to a totally new pathogen.”

Such antibodies could be ready long before a vaccine and could give temporary vaccine-like protection to some people such as the elderly and healthcare workers as well as those patients who tested positive.

Identifying neutralising antibodies from recovered patients and then giving them to new patients has previously been successful.

The approach has been used for deadly viruses like Ebola and respiratory syncytial virus (RSV) infection, a common cause of pneumonia.

These antibodies can be manufactured in large quantities and, since they circulate in the patient’s blood for a few weeks, they last long enough to fight off the infection.

Dr Elise Landais, study co-author, said:

“We leveraged our institution’s decades of expertise in antibody isolation and quickly pivoted our focus to SARS-CoV-2 to identify these highly potent antibodies.”

The research team took antibody blood samples from recovered patients to be used in developing test cells similar to ACE2 receptors.

SARS-CoV-2 binds to these receptors to infect and destroy healthy human cells.

The team then tested these antibodies to see if they can attach to the virus and stop them from infecting the test cells.

The team found several antibodies that could protect the test cells against the infection.

The researchers say if clinical trials go well then the anti-SARS-CoV-2 antibodies would be ready by January 2021.

Dr Landais said:

“We intend to make them available to those who need them most, including people in low- and middle-income countries.”

Dr Thomas Rogers, the study’s first author, said:

“It has been a tremendous collaborative effort, and we’re now focused on making large quantities of these promising antibodies for clinical trials.”

In addition to identifying anti-SARS-CoV-2 antibodies the team found a neutralising SARS-CoV antibody.

SARS-CoV is the virus responsible for the severe acute respiratory syndrome (SARS) outbreak in Asia during 2002 to 2004.

Dr Burton  said:

“That discovery gives us hope that we will eventually find broadly neutralizing antibodies that provide at least partial protection against all or most SARS coronaviruses, which should be useful if another one jumps to humans.”

The study was published in the journal of Science (Roger et al., 2020).

2 Personality Traits Linked To Stockpiling Toilet Paper

The reason people stockpiled toilet paper in the pandemic.

The reason people stockpiled toilet paper in the pandemic.

Conscientious and emotional people were the most likely to stockpile toilet paper in March 2020, a new study finds.

Despite calls from governments around the world to avoid panic buying, sales of toilet paper went up 700 percent in response to the pandemic.

But why toilet paper?

Apparently, people feel safer with more toilet paper in the house.

The study’s authors write:

“…people experience an increased sensitivity to disgust in times of a spreading disease and toilet paper is hypothesized to serve as a symbol of safety alleviating the perceived threat.

Consequently, stockpiling toilet paper during the Covid-19 pandemic should be observed primarily among those who feel particularly threatened by the virus.”

The study included 966 people in 22 countries who were given personality tests and asked about their toilet paper consumption in recent weeks.

The results showed that people who felt most threatened by the pandemic were more likely to stockpile toilet paper.

High emotionality — often known as neuroticism — was the personality trait that most strongly predicted toilet paper stockpiling.

Emotional people are those who tend to worry and feel more anxious.

The other personality trait linked to stockpiling toilet paper was conscientiousness.

People who are conscientious tend to be perfectionist, hard workers who prefer planning ahead.

The study also found that older people and Americans were more prone to stockpiling than the young and European.

Although stockpiling has been labelled selfish, the threat that people faced has a strong effect, the authors write:

“Although stockpiling as a result of perceived threat might be considered selfish by some, it is important to note that it would not necessarily reflect a dispositional lack of prosociality.

Instead, even the most humble and moral individuals might stockpile toilet paper as long as they feel sufficiently threatened by the pandemic.”

The study was published in the journal PLOS ONE (Garbe et al., 2020).

COVID-19 Can Trigger Diabetes In Healthy People

There is a two-way relationship between COVID-19 and diabetes.

There is a two-way relationship between COVID-19 and diabetes.

Coronavirus could cause diabetes in previously healthy patients and also lead to serious complications of pre-existing diabetes, such as a hyperosmolar hyperglycemic state, evidence shows.

Hyperosmolar syndrome is a condition triggered by an infection or illness in diabetics who have extremely high blood sugar.

Clinical cases reported a two-way relationship between diabetes and COVID-19.

We now know that diabetes increases the odds of severe illness and death from coronavirus.

About 30 percent of COVID-19 patients who died have been found to be diabetics.

On the other hand, experts from the CoviDiab Registry project say that individuals who are infected by SARS‐CoV‐2 could develop diabetes and its life-threatening complications.

Although it is not completely clear yet how the virus affects diabetes, a study has revealed that SARS-Cov-2 will enter human cells by binding to ACE2.

ACE2, which is a protein-coding gene, is located in the human tissues, lungs, heart, arteries, and other organs such as liver, pancreas and kidney and is involved in a process that breaks down glucose (blood sugar) to energy.

When the virus enters these organs it probably causes serious abnormalities and disruption to this process, as for years it has been thought that virus infections can cause type 1 diabetes.

Professor Francesco Rubino, lead investigator of the CoviDiab Registry project, said:

“Diabetes is one of the most prevalent chronic diseases and we are now realizing the consequences of the inevitable clash between two pandemics.

Given the short period of human contact with this new coronavirus, the exact mechanism by which the virus influences glucose metabolism is still unclear and we don’t know whether the acute manifestation of diabetes in these patients represent classic type 1, type 2 or possibly a new form of diabetes”.

Professor Paul Zimmet, co-investigator of the CoviDiab Registry project, said:

“We don’t yet know the magnitude of the new onset diabetes in COVID-19 and if it will persist or resolve after the infection; and if so, whether or not or COVID-19 increases risk of future diabetes.

By establishing this Global Registry, we are calling on the international medical community to rapidly share relevant clinical observations that can help answer these questions”.

Professor Stephanie Amiel, co-investigator of the CoviDiab Registry project, said:

“The registry focuses on routinely collected clinical data that will help us examine insulin secretory capacity, insulin resistance and autoimmune antibody status to understand how COVID-19 related diabetes develops, its natural history and best management.

Studying COVID-19-related diabetes may uncover novel mechanisms of disease.”

The study was published in the New England Journal of Medicine (Rubino et al., 2020).

A Common Drug That Reduces COVID Deaths

A widely available medicine could save one-third of patients hospitalised with COVID-19.

A widely available medicine could save one-third of patients hospitalised with COVID-19.

One-third of coronavirus patients who are seriously ill and suffering from severe respiratory complications can be saved with a common steroid treatment.

Dexamethasone is a corticosteroid, which is a class of steroid hormone that works as an anti-inflammatory.

A study called the RECOVERY trial tested this cheap and readily available drug on COVID-19 patients.

They found that dexamethasone saved one-third of patients who were on ventilators and reduced deaths by a fifth for patients receiving oxygen.

Researchers say, due to its low cost, it could also benefit poorer countries.

They believe it can be used right away to save many lives of seriously ill patients with COVID-19 worldwide.

Professor Martin Landray, the study’s lead researcher, said:

“Since the appearance of COVID-19 six months ago, the search has been on for treatments that can improve survival, particularly in the sickest patients.

These preliminary results from the RECOVERY trial are very clear – dexamethasone reduces the risk of death among patients with severe respiratory complications.

COVID-19 is a global disease – it is fantastic that the first treatment demonstrated to reduce mortality is one that is instantly available and affordable worldwide.”

In this trial, 2,104 patients received a daily dosage of 6 mg of dexamethasone for ten days.

The highest death rate was amongst those patients on ventilators, intermediate for those needing oxygen, and lowest for those patients who didn’t need any respiratory support.

Dexamethasone cut the risk of death in ventilated patients from 40 percent to 28 percent compared with those who were not on dexamethasone.

It also reduced the risk of death from 25 percent to 20 percent in other patients who were on oxygen.

However, dexamethasone treatment didn’t benefit those patients who didn’t need respiratory interventions, suggesting it helps prevent death only in seriously ill patients.

Professor Peter Horby, a principal investigator for this trial, said:

“Dexamethasone is the first drug to be shown to improve survival in COVID-19.

This is an extremely welcome result.

The survival benefit is clear and large in those patients who are sick enough to require oxygen treatment, so dexamethasone should now become standard of care in these patients.

Dexamethasone is inexpensive, on the shelf, and can be used immediately to save lives worldwide.”

Dexamethasone, due its anti-inflammatory effects, is usually prescribed for conditions such as patients with asthma, skin problems, and arthritis.

It is probable that it prevents the immune system from overreacting, which is known as cytokine storm.

Cytokine storm is seen in patients with respiratory diseases, flu, and COVID-19.

At the moment, US doctors suggest caution over the ‘breakthrough’ claims on dexamethasone and want to see the complete published results and understand potential side-effects in order to make a decision.

The results come from the RECOVERY (Randomised Evaluation of COVid-19 thERapY) trial, which is not published yet.

All COVID Patients Develop Antibodies, Study Finds

But are the antibodies produced enough to block reinfection?

But are the antibodies produced enough to block reinfection?

All patients recovered from coronavirus disease develop a neutralizing antibody (NAb) that keeps the virus ineffective, new research finds.

However, the levels may not be adequate in everyone to guarantee they won’t be reinfected.

The immunological study on 149 recovered COVID-19 patients suggests that the immune system is able to produce antibodies but the levels are different in everybody.

Despite the wide variation in antibody levels in recovered patients, many had developed some natural immunity to fight the SARS-CoV-2 virus.

Some antibodies are more effective than the others.

Although many can attach onto the surface of the virus and inactivate it, only some antibodies are absolutely capable of neutralising the infectious agent by blocking it from invading cells.

Professor Michel C. Nussenzweig, study co-author, said:

“This suggests just about everybody can do this, which is very good news for vaccines.

It means if you were able to create a vaccine that elicits these particular antibodies, then the vaccine is likely to be effective and work for a lot of people.”

The neutralising effect couldn’t be detected in 33 percent of people.

It is possible that their immune systems dealt with the infection before the cells that produce antibodies got involved.

Most individuals had small quantities of neutralising antibodies and only 1 percent showed high neutralising activity.

Dr Davide Robbiani, the study’s first author, said:

“Like in other diseases, everyone responds differently.

Some people have poor response, some average.

And then there is a fraction of people that are exceptional responders.”

The 1 percent of exceptional or “elite” responders are important as there is a chance that experts could identify the rare immune cells that produce them.

Then they would be able to duplicate the antibodies from these cells and produce a drug that can mimic the same robust defence in other humans.

Various antibodies are generated by elite responders but 40 antibodies were responsible for neutralizing the virus in which three specific antibodies were shown to be the most powerful ones against COVID-19.

The researchers are now focusing on these three antibodies for further development of drugs in treating or preventing the coronavirus infection.

Dr Robbiani said:

“We now know what an effective antibody looks like and we have found similar ones in more than one person.

This is important information for people who are designing and testing vaccines.

If they see their vaccine can elicit these antibodies, they know they are on the right track.”

The study was published in BioRxiv (Robbiani et al., 2020).

How Warmer Weather Affects Spread Of COVID-19

Study reveals how warmer weather may affect the transmission of COVID-19.

Study reveals how warmer weather may affect the transmission of COVID-19.

During summer the transmission rates of most respiratory viral infections such as influenza will drop.

Several studies on SARS-CoV-2  have shown that its survival rate is shorter in higher temperatures and UV light inactivates the virus.

However, until now the effects of temperature, UV light, and precipitation on how quickly the virus is transmitted between people has not been investigated.

The question is whether warmer temperature, UV light, and humidity can lower or even curb the rapid spread of SARS-CoV-2.

A research team assessed the link between weather conditions including precipitation, UV index, and temperature and the number of coronavirus cases during spring 2020 in the U.S.A..

They found that higher temperature up to 52 degrees Fahrenheit (11 degrees Celsius) reduced the incidence of COVID-19.

However, any higher temperatures didn’t have much impact on reducing disease transmission.

Precipitation patterns didn’t affect the spread rate but a higher UV index was found to lessen the number of new cases.

Dr Shiv T Sehra, the study’s first author, said:

“While the rate of virus transmission may slow down as the maximum daily temperature rises to around 50 degrees, the effects of temperature rise beyond that don’t seem to be significant.

Based on our analysis, the modest association suggests that it is unlikely that disease transmission will slow dramatically in the summer months from the increase in temperature alone.”

Furthermore, they checked if changes in temperature had any impact on the spread of SARS-CoV-2 between January and April 2020.

They used a model for five different scenarios as follows: above 60 degrees °F (16 °C), between 50-60 degrees °F (10 °C – 16 °C), between 40-50 degrees °F (4 °C – 10 °C), between 30-40 degrees °F (-1 °C – 4 °C), and less than 30 degrees °F (-1 °C).

The days that the temperature was above 50 degrees °F showed the lowest number of new COVID-19 cases.

While the days where the temperature was below 30 degrees °F had the maximum hike in infection rates.

According to The Centers for Disease Control and Prevention, through the fall and winter as temperatures drop the coronavirus pandemic might get worse.

Dr Sehra noted:

“Our results are in line with those predictions.

We also caution that the disease may get worse in the fall and winter months.”

One study limitation is that the collected data reflect spring when the daily maximum temperature was below 70 degrees Fahrenheit (21 degrees Celsius) whereas summer temperatures in most parts of the country will be much higher than that.

Consequently, this study can’t assess the possible effects of temperatures above 70-75 degrees Fahrenheit on COVID-19 virus transmission.

The study was published in the journal Clinical Infectious Diseases (Sehra et al., 2020).

These Masks Reduce COVID Transmission By 90%

The types of face covering that could protect a person from coronavirus transmission risk.

The types of face covering that could protect a person from coronavirus transmission risk.

Face masks and any other mouth and nose covers can lower the forward distance transmission risk of COVID-19 by 90 percent.

A group of engineers has examined seven types of protective face masks, such as homemade masks and surgical masks and found that all are effective in minimising COVID-19 spread.

Dr Cathal Cummins, study co-author, explained the results:

“Even our hand-made mask performed very well in preventing the frontal spread of the wearer’s exhaled breath.

While this is positive, wearers of hand-made face masks need to be aware that jets of air can leak out of the sides and back of their masks.

This could be particularly important when using masks on public transport, where sitting behind someone wearing a mask could be more of a hazard than sitting directly facing them.”

However, exhaled air could still escape from the sides and back of some face covers.

A background oriented schlieren (BOS) imaging technique was used to measure the direction and distance that air travels when a person coughs or breathes through a face covering.

The team discovered that all face masks with no outlet valve decrease how far a deep breath travels by over 90 percent.

Respirator masks worn by workers who are exposed to dust provide some protection but the valves could lead to the spread of infectious air in front.

Handmade covers and surgical masks were shown to minimise exhaled air travelling forwards but produced leakage jets below, above, behind, and to the sides.

In particular, strong backward jets were produced by coughing and breathing heavily.

The researchers found that only tight-fitting masks could block virus-filled droplets.

They also found that intense downward jets were discharged when wearing full-face shields only.

The team found that extubation, a routine medical procedure to remove a breathing tube used in patients on ventilators, increases the spread of coronavirus risk.

Coughing due to extubation would put practitioners at extreme risk of the virus as well as anyone close by.

Dr Felicity Mehendale, study co-author, said:

“It was reassuring to see the hand-made mask worked just as well as the surgical mask to stop the wearer’s breath flowing directly forwards.

This suggests that some hand-made masks can help to prevent the wearer from infecting the public.

But, the strong backward jets mean you need to think twice before turning your head if you cough while wearing a mask; and be careful if you stand behind or beside someone wearing a mask.”

The study was published in arXiv (Viola et al., 2020).

COVID-19: How People Are Coping Mentally

The most popular ways of dealing with the pandemic.

The most popular ways of dealing with the pandemic.

People are coping with the pandemic by increasing their use of self-care, a new survey finds.

Self-care strategies include exercising, stress management, healthy diet and other changes like giving up smoking.

Among the most popular types of self-care are creative activities, praying and having meaningful conversations with friends and family.

People are also eating more healthy foods and spending more time outdoors.

Dr Wayne Jonas, the study’s first author, said:

“The pandemic threatens the mental and physical well-being of every American.

People are seeking ways to manage their stress, but it isn’t enough.

As we adjust to a new normal, we need to foster a robust, patient-centered healthcare system to better promote self-care.”

The results come from an online poll of 2,051 people in the US.

Almost two-thirds of Americans said they are more focused on their mental health now than ever before.

Most Americans (80 percent) said that they will be more mindful of their self-care in the future.

Typical problems people are experiencing include:

  • Social isolation (47 percent),
  • lack of energy (30 percent),
  • problems sleeping (29 percent),
  • and less exercise (29 percent).

People also report being scared to seek medical attention they may need (55 percent).

Dr Jonas said:

“At a time when healthcare is needed the most, a majority of people are scared to seek it out.

This not only leaves them without critical immediate care, it also halts necessary preventative care that is vital to chronic disease prevention and management.

This change in healthcare access will likely have dangerous repercussions for the long-term health of our country.

These are also the same risk factors that increase serious illness from COVID-19.”

Dr Jonas summarised:

“The findings from this study show the critical need for a system that empowers individuals to maintain healthy habits they formed and emphasizes strategies that support self-care–like good nutrition, exercising, and stress reduction–alongside guidance from physicians.”

The Social Isolation Survey was conducted online by The Harris Poll on behalf of Samueli Integrative Health Programs.

The Indigestion Drug That Treats COVID-19

An over-the-counter drug may put COVID-19 symptoms on a tight leash.

An over-the-counter drug may put COVID-19 symptoms on a tight leash.

A commonly used medicine for treating indigestion could also be a worthy candidate to fight off coronavirus symptoms.

Famotidine is a prescription drug that is sold under various brand names including ‘Pepcid AC’.

The medicine relieves heartburn and acid reflux by reducing the production of stomach acid.

Famotidine dosage can be from 20 to 160 milligram taken up to four times a day.

A study suggests that famotidine can also minimise the symptoms of COVID-19 in patients with mild to moderate symptoms.

A small group of COVID-19 patients, within 24 to 48 hours of taking famotidine, experienced a quick improvement of symptoms and had recovered from the infection in 14 days.

A large clinical trial is going to test famotidine to see if it could be an effective medicine for treating SARS-CoV-2 infection.

The report includes 10 COVID-19 patients aged from 23 to 71 with different ethnicities who started taking famotidine during their sickness.

At the point of taking famotidine, some of them had been experiencing the coronavirus symptoms for 26 days.

Shortness of breath, cough, loss of taste and smell, headache, and fatigue were the common symptoms.

The average dose of famotidine was 80 mg taken three time per day and most recovered in 11 days.

All of them reported that their symptoms were improved less than 48 hours after taking famotidine and most symptoms were gone in 14 days.

All symptoms were improved, but respiratory problems including shortness of breath and cough disappeared much faster than systemic issues like fatigue.

Except for three patients who experienced mild side-effects, the rest did not have any side-effects from taking famotidine.

However, the authors caution:

“Our case series suggests, but does not establish, a benefit from famotidine treatment in outpatients with COVID-19.”

The effect of famotidine on the virus is not clear yet but there is a chance that somehow it disables the virus or changes the immune responses to the virus.

The authors said:

“Clinically, we unreservedly share the opinion that well designed and informative studies of efficacy are required to evaluate candidate medications for COVID-19 as for other diseases.”

Even so, a more detailed clinical trial is already started to look into the combined effect of the antimalarial drug hydroxychloroquine with famotidine in hospitalized patients with COVID-19.

The authors concluded:

“An outpatient study of oral famotidine that investigates efficacy for symptom control, viral burden and disease outcome and assesses the effects of medication use on long term immunity should be considered to establish if famotidine may be of use in controlling COVID-19 in individual patients while also reducing the risk of SARS-CoV-2 transmission.”

The study was published in the journal GUT (Janowitz et al., 2020).