Category: COVID19

Patients with COVID-19 who have high levels of this hormone are at greater risk.

Cortisol, which is known as the stress hormone, puts individuals who have been tested positive for coronavirus disease at higher risk of death.

COVID-19 patients with a high cortisol level are in danger of declining very fast and dying, a study has found.

It also suggests that cortisol levels in the blood can signal how severe the illness is and so it can be a useful marker to single out those patients in need of critical care.

When we are under stress our body produces cortisol: a steroid hormone to help us deal with the problem.

Cortisol levels would rise with issues like changes in metabolism, high blood pressure, heart disease, illnesses, and immune response.

The highest levels of cortisol in healthy people occur naturally in the morning and the lowest at night during sleep.

In healthy situations or while resting, serum cortisol concentration is from 100 to 200 nmol/L and when we sleep the levels go down to almost zero.

Low or high cortisol levels are similarly dangerous and potentially fatal as they can damage the immune system seriously and increase the risk of all sorts of infections.

The study found that cortisol levels in a group of patients with COVID-19 were considerably higher compared to the patient group without COVID-19.

The cortisol stress responses in the patients with COVID-19 reached a range up to 3,241 nmol/L.

This was much higher even than patients who undergo major surgery, when generally levels stay below 1,000 nmol/L.

The average survival for those COVID-19 patients with cortisol concentration of 744 nmol/L or less was 36 days and it got worse for those with cortisol values over 744 nmol/L as they only lived for an average of 15 days.

Professor Waljit Dhillo, the study’s lead author, said:

“From an endocrinologist’s perspective, it makes sense that those COVID-19 patients who are the sickest will have higher levels of cortisol, but these levels are worryingly high.

Three months ago when we started seeing this wave of COVID-19 patients here in London hospitals, we had very little information about how to best triage people.

Now, when people arrive at hospital, we potentially have another simple marker to use alongside oxygen saturation levels to help us identify which patients need to be admitted immediately, and which may not.

Having an early indicator of which patients may deteriorate more quickly will help us with providing the best level of care as quickly as possible, as well as helping manage the pressure on the NHS.

In addition, we can also take cortisol levels into account when we are working out how best to treat our patients.”

The death rate throughout the study period for patients in the COVID-19 group was 27.8 percent whereas the rate for the non-COVID group was 6.8 percent.

The study was published in The Lancet Diabetes & Endocrinology (Tan et al., 2020).

So far Omicron symptoms have proved milder than those associated with the previously dominant Delta variant.

Omicron symptoms and signs to look out for have proved different to the other variants of COVID, such as Delta.

So far Omicron symptoms have also been generally milder than those associated with the previously dominant Delta variant.

There are five signs that are often seen in cases of the Omicron variant of COVID:

• a scratchy, dry throat,
• extreme tiredness,
• runny nose,
• sneezing,
• and headache.

The scratchy, dry throat is in contrast to Delta variant COVID, which tends to produce a sore throat and a dry, persistent cough.

Fever and sense of smell

The Omicron variant is not so strongly linked to some other signs that are frequently connected to COVID.

For example, a loss of the sense of smell does not seem to be linked to Omicron.

Similarly, people with Omicron are not reporting a high fever as often.

Infection with the Omicron variant can be difficult to diagnose without testing because the symptoms vary between people.

It will depend on the person’s age, their vaccination status and other biological factors specific to them.

Some people may experience a very heavy cold, others lighter symptoms and others no symptoms at all.

Having been infected with the Delta variant of COVID before, though, is no guarantee of avoiding Omicron.

Because the virus has mutated, it is possible to catch Omicron even after prior infection with Delta.

However, both prior infection and vaccination are very likely to reduce the risk of serious symptoms and hospitalisation.

COVID testing

A PCR test is currently the best widely available way to test for a COVID infection.

Follow-up gene sequencing can help to determine the COVID variant.

The Omicron variant is spreading rapidly around the world.

In some part of the U.S. it now accounts for 15 percent of all cases of COVID.

It is thought to spread at least twice as fast as the Delta variant.

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Do Omicron symptoms look like a common cold?

During winter time, viruses circulate more easily and due to lack of sunlight our immune system can be affected negatively, therefore, we are more likely to catch a cold.

COVID and other respiratory infections like influenza are rapidly transmitted between people.

Infected people with symptoms or without can spread the virus.

COVID is more contagious than flu viruses and some of its variants, such as Omicron, spread through people even more quickly.

Omicron is the latest strain of COVID, but due to its cold-like symptoms, it is harder to distinguish from a heavy cold.

The warning signs associated with Omicron to look out for are:

• Mild or severe fatigue
• Scratchy throat
• Dry cough
• Headache
• Runny nose
• Sneezing
• Muscle aches

PCR tests for COVID can detect the SARS-COV-2 virus, but genome sequencing will flag which variant a person is infected with.

The limited data on Omicron suggests that this specific strain is quite different with other COVID variants.

Omicron shares many similar symptoms with a common cold while classical COVID symptoms including loss of taste or smell, fever, and continuous cough are less likely.

According to the ZOE COVID Symptom study, the top five signs for Omicron infection include fatigue, runny nose, sneezing, headache, and sore throat.

Despite that, the UK government still lists loss of sense of smell or taste, cough, and fever, which are the common symptoms of the other COVID variants.

Professor Tim Spector, the lead scientist of this report, said the symptoms should have been updated earlier:

“The messaging from the government is just not clear on this.

I think most people know what cold-like symptoms are.

I would probably just add [to the list]: ‘Have you got cold-like symptoms?’

We need to educate people, go back to the basics, and say that if you’ve got cold-like symptoms keep away from people.

You shouldn’t be waiting for the three classic symptoms.”

Professor Spector emphasises that the public needs to be informed about what symptoms to watch out for, especially in cities like London where the Omicron infection rate is very high.

“If you do have symptoms of a mild or bad cold, it’s highly likely that you’ve got COVID if you’re in an area like London at the moment.”

A study by Zhang et al., on Omicron suggests that people vaccinated against COVID and those previously infected will have  a stronger defence against this new variant.

The study was published in the journal Emerging Microbes & Infections (Zhang et al., 2021).

Two risk factors for getting COVID that you can control.

Getting sufficient sleep and avoiding workplace burnout can significantly decrease the risk of getting COVID.

New research has found that both sleep problems and job burnout are linked to a higher risk of catching COVID.

People feeling burnt out and experiencing poor sleep are also more likely to get severe COVID and for the disease to last longer.

The conclusions come from a study of almost 3,000 frontline healthcare workers in the US, France, Germany, Italy, Spain and the UK.

The study’s authors write:

“We found that lack of sleep at night, severe sleep problems and high level of burnout may be risk factors for COVID-19 in frontline [healthcare workers].

Our results highlight the importance of healthcare professionals’ well-being during the pandemic.”

For each extra hour that people spend in bed, their odds of being infected with COVID were reduced 12 percent.

People in the study were asked if they had typical sleep problems, such as difficulties falling asleep, staying asleep or needing sleeping pills.

People with three or more sleep problems were at a 88 percent higher risk of developing COVID.

Burnout

Similarly, feeling burnt out on a daily basis more than doubled the odds that someone would develop COVID.

The three signs of burnout are:

1. Feelings of energy depletion or exhaustion,
2. increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job,
3. and reduced professional efficacy.

Burnout tripled the odds that those that caught COVID would experience severe symptoms.

Although the study did not probe the reason for the link between poor sleep, burnout and COVID, the authors write:

“The mechanism underlying these associations remains unclear, but it has been hypothesized that lack of sleep and sleep disorders may adversely influence the immune system by increasing proinflammatory cytokines and histamines.”

Dr Minha Rajput-Ray, commenting on the study, said:

“Disruptions to the sleep-wake cycle can affect metabolic, immune and even psychological health.

And sleep deprivation can make calorie dense foods, higher in fat, sugar and salt, more appealing, particularly during times of stress and/or difficult shift patterns, all of which takes a toll on overall health and wellbeing.”

→ Read on: the mental techniques that boost your immune system and how to boost your immune response to the COVID vaccine.

The study was published in BMJ Nutrition, Prevention & Health (Kim et al., 2021).

People with this blood type are less vulnerable to coronavirus infection.

Human ABO blood groups could possibly have some effect on susceptibility to COVID-19 and its severity.

Studies suggest that while people with blood types A and AB may be more likely to develop severe COVID, individuals with blood type O are less likely to contract an infection.

Those with blood type O appear to be less vulnerable to the virus and so they have the lowest risk of developing serious illness, followed by hospitalization and death.

While the coronavirus pandemic goes on, scientists are trying to determine the risk factors and find ways to minimize them.

Blood type appears to be a potential risk factor associated with COVID and the severity of the illness in infected patients.

A Danish study compared data from nearly half a million people tested for COVID with more than two million non-tested individuals (control group).

The research team found that more people with A, AB, and B blood types tested positive for coronavirus but fewer people with blood type O tested positive.

The scientific evidence suggests that blood type O has the ability to protect its owner from coronavirus infection.

Blood group O has no antigens but contains anti-A and anti-B antibodies that are able to neutralize the virus when entering human cells.

Dr Torben Barington, the study’s senior author, said:

“It is very important to consider the proper control group because blood type prevalence may vary considerably in different ethnic groups and different countries.

We have the advantage of a strong control group — Denmark is a small, ethnically homogenous country with a public health system and a central registry for lab data — so our control is population-based, giving our findings a strong foundation.”

Another study collected data on 95 severely ill patients hospitalized with COVID.

They found that mechanical ventilation was needed for a high number of COVID patients with blood group A or AB compared to blood groups O or B patients.

Overall, critically ill COVID patients with blood group A or AB were more likely to face lung injury, liver dysfunction, kidney  failure, and have extended treatment in the intensive care unit (ICU).

According to a study by Dr Sean Stowell and colleagues, people with blood type A are more likely to test positive for the novel coronavirus.

This is because the coronavirus prefers blood group A antigens that are on the respiratory cells.

The studies were published in the journal Blood Advances (Hoiland et al., 2020 & Barnkob et al., 2020).

The systemic and local side-effects of Pfizer-BioNTech and Oxford-AstraZeneca COVID vaccines.

One-quarter of people who receive either the AstraZeneca or Pfizer COVID vaccines experience systemic effects.

Headache, fatigue, tenderness and pain around the injection site are the most common systemic and local effects but they were mild and do not last long, a UK real-world study found.

Systemic effects are adverse reactions affecting the whole body except for the site of contact: these include fatigue, headache, joint pain, myalgia, fever, chills and shiver, nausea, and diarrhoea.

Local effects are those adverse reactions that occur at the site of injection which include tenderness, swelling, pain in the arm, itch, warmth, redness, and swollen lymph nodes in the armpit.

Allergic skin reactions were also reported by some people across both types of vaccine, including red welts on face and the lips, rashes, and skin burning.

Most side-effects were minor in severity occurring during the first 24 hours after vaccination and often lasting up to 2 days.

The data was gathered from 627,383 users of the ZOE COVID Symptom Study app in the UK.

In addition, the study found that infection rates dropped by 58 percent 12 days after the first dose of the Pfizer vaccine but for AstraZeneca it was a 39 percent.

The reduction in infection rates at 21–44 days after the first injection for Pfizer was 69 percent and for AstraZeneca 60 percent.

Here is a brief summary of the outcomes:

• 25.4 percent of participants experienced one or more systemic adverse effects and 66.2 percent had one or more local adverse effect.
• 22.8 percent of people suffered from headaches after the first dose of the AstraZeneca vaccine while 7.8 percent of people after the first Pfizer jab and 13.2 percent after the second Pfizer dose reported headaches.
• 21.1 percent of people experienced fatigue while 8.4 percent of people had fatigue after the first Pfizer jab and 14.4 percent after the second dose of Pfizer.
• Tenderness was the most common local effect: 49.3 percent after the first dose of AstraZeneca, 57.2 percent after the first Pfizer jab and 50.2 percent after the second dose of Pfizer.

It appears that side-effects were more common among women and people who were 55-years-old or younger.

People with a previous COVID infection were 3 times more likely to suffer from vaccine related side-effects.

Professor Tim Spector, the study’s senior author, said:

“The data should reassure many people that in the real world, after effects of the vaccine are usually mild and short-lived, especially in the over 50’s who are most at risk of the infection.

Rates of new disease are at a new low in the UK according to the ZOE app, due to a combination of social measures and vaccination and we need to continue this successful strategy to cover the remaining population.

The results also show up to 70% protection after 3 weeks following a single dose, which is fantastic news for the country, especially as more people have now had their second jabs.”

The study was published in the Lancet Infectious Diseases (Menni et al., 2021).

This behaviour is one of the biggest risk factors for COVID-19 severity and death.

People who live a sedentary lifestyle which involves little or no physical activity are more likely to develop severe COVID-19 infection and die from the illness.

According to a large US study, COVID patients who had a sedentary lifestyle during the 2 years before the pandemic were at a higher risk of hospitalisation, admission to intensive care units (ICUs), and death than those who had some physical activity.

In fact, physical inactivity was the third biggest risk factor for severe disease after being old and having had an organ transplant.

Pervious research has suggested that the risk of getting severely ill from COVID-19 increases with age, sex (being a male), obesity, cardiovascular disease, and diabetes.

Despite the fact that being sedentary is associated with many chronic health conditions, none of these studies identified physical inactivity as a risk factor for severe COVID outcomes.

This study tracked 48,440 obese COVID patients to see whether physical inactivity has any effect on severity of coronavirus disease.

Activity levels were categorised into:

• consistently meeting physical activity guidelines (150 minutes or more per week),
• some activity (11 to 149 minutes per week),
• and consistently inactive (zero to 10 minutes per week).

Data analysis showed a strong link between consistently meeting physical activity guidelines and lower risk of severe outcomes from COVID.

Consistently inactive COVID patients were at twice the risk of hospitalisation than those who were active for 150 minutes or more per week.

Moreover, inactive patients were 73 percent more likely to be taken to the ICU and 2.5 times more likely to die of the infection.

Compared to those who were doing some physical activity, the consistently inactive group had a 20 percent higher risk of hospitalisation, 20 percent higher risk of ICU admission, and 32 percent higher risk of death.

The authors remarked:

“It is notable that being consistently inactive was a stronger risk factor for severe COVID-19 outcomes than any of the underlying medical conditions and risk factors identified by [The Centers for Disease Control] except for age and a history of organ transplant.

In fact, physical inactivity was the strongest risk factor across all outcomes, compared with the commonly cited modifiable risk factors, including smoking, obesity, diabetes, hypertension [high blood pressure], cardiovascular disease and cancer.”

They added:

“Engaging in regular [physical activity] may be the single most important action individuals can take to prevent severe COVID-19 and its complications, including death.

This message is especially important given the increased barriers to achieving regular [physical activity] during lockdowns and other pandemic restrictions.”

The study was published in the British Journal of Sports Medicine (Sallis et al., 2021).

High blood sugar puts COVID patients at high risk of needing a ventilator or admission to an intensive care unit.

COVID patients with high blood sugar, whether they have diabetes or not, suffer worse outcomes and increased risk of death.

Hyperglycemia or high blood glucose is a condition that happens when not enough insulin is produced or used by the body.

However, stress, certain medications, illness, lack of exercise, and excessive eating can lead to this condition.

A study examined the effect of hyperglycemia in coronavirus patients and found that these patients experienced worse health problems, no matter if they were diabetics or not.

Patients hospitalised for COVID who had high blood sugar were more likely to be put on a ventilator or admitted to the intensive care unit (ICU), develop an acute kidney injury (AKI), and die in hospital.

Dr Samara Skwiersky, the study’s lead author, said:

“COVID-19 patients presenting to the hospital with hyperglycemia require closer observation, as they are likely to require more aggressive therapies.”

The research team looked into undesirable COVID outcomes in 708 adults by measuring their blood glucose levels.

Hospitalisation of a patient with diabetes is recommended when the blood glucose values are between 140 and 180 mg/dL.

The study found that diabetes patients with a blood glucose value of over 140 mg/dL were 2.4 times more likely to need a breathing machine and be admitted to ICU.

The undesirable COVID outcomes got worse in diabetic patients with blood glucose levels of over 180 mg/dL as they were twice as likely to die in hospital.

However, patients who were not diabetics, but had a blood glucose level of over 140 mg/dL, were twice as likely to die of COVID.

Also, the odds of intubation and developing AKI were increased by 2.3 times and the risk of ending up in ICU was 3.5 times higher for these patients.

The odds of intubation and ICU admission was almost tripled and death risk was quadruple for those without diabetes but with a blood glucose level of over 180 mg/dL.

Dr Skwiersky said:

“The results from our study, reiterate the importance of regularly monitoring blood glucose in patients hospitalized with COVID-19, even without a prior diagnosis of diabetes.”

She added:

“More frequent glucose monitoring and treatment with insulin therapy to a target glucose value less than 140 mg/dL could improve outcomes in these patients.”

The study was presented at ENDO 2021, the Endocrine Society’s annual meeting.