190 CMAAO CORONA FACTS and MYTH COVID CDC
Immunity Three Months
Dr K Aggarwal
President CMAAO
1056: Second Sero-survey suggests 28% in city
have antibodies
X
1. The previous
serological survey carried out by the National Centre for Disease Control on a
sample size of 21,387 showed that 22.86% of the people surveyed had been
exposed to the virus.
2.
The second round of serological
survey, conducted in the first week of August across the national capital, has
suggested that 28.35% of the people tested have developed antibodies.
3.
More than 15,000 samples were
lifted across 11 districts in Delhi to assess the spread of the virus. The
samples were processed in 18 labs authorised by the state government for the
rigorous exercise.
4.
The data collated by researchers
at Maulana Azad Medical College has been submitted to Principal Health
Secretary Vikram Dev Dutt.
5.
The highest prevalence has been
reported from the central district
6.
Sampling taken: 25 %
less than 18 years, 18-49 years 50% and 25% over 50 years of age
7.
Antibodies in males 28.3%
8.
Antibodies in females 32,2%
9.
Less than 18 years antibodies in 34.7%
10. 18-49
years 28.5%
11. Over
50 years 31.2%
1057: A top ICMR official told a parliamentary panel on
Wednesday that phase-two clinical trial of two indigenously developed Covid-19
vaccine candidates have almost been completed and emergency authorisation of a
vaccine could be considered if the Centre decides so.
1058: What
is vaccine nationalism: The countries with more money are striking pre-purchase deals
with pharma companies to buy coronavirus vaccine once the trials prove
successful. Since, several companies across the world are researching on a
Covid-19 vaccine, the wealthier nations have already placed orders worth
millions to get their citizens the first shots.
1059: Cohort isolation: Patients should be placed in a well-ventilated
single-occupancy room with a closed door and dedicated bathroom. When this is
not possible, patients with confirmed COVID-19 can be housed together. Patients
with confirmed COVID-19 should not be in a
positive-pressure room. An airborne infection isolation room (AII; ie, a
single-patient, negative-pressure room) should be prioritized for patients
undergoing aerosol-generating procedures.
1060: Kidney a 'Bystander' in COVID-19: A new Canadian study has found increased
expression of angiotensin-converting enzyme 2 (ACE2) receptors in the kidneys
of patients with diabetic nephropathy,
which may help explain why such patients are at higher risk of COVID-19 and
have severe outcomes. However, that SARS-CoV-2 virus directly infects the
kidneys has not been proven so far. Kidney damage may be the by-product of the
novel coronavirus wreaking havoc elsewhere in the body. The new study has been
published as a journal preproof in
the Canadian Journal of Diabetes by Richard Gilbert, MD, Canada
Research Chair in Diabetes Complications, St Michael's Hospital, Toronto,
Ontario, and colleagues.
1061: More data from observational studies, this time in
hospitalized patients, indicated that famotidine (Pepcid AC), which is used to
treat heartburn, was associated with improved clinical outcomes in COVID-19
patients. Use of famotidine in a small group of 83 patients was associated with
a lower risk of in-hospital mortality and a combined outcome of death and
intubation, reported Jeffrey Mather, MS, of Hartford Hospital in Connecticut,
and colleagues.
1062: Study
shows SARS-CoV-2 causes a specific dysfunction of the kidney proximal tubule: Findings from a study published in Kidney
International show that SARS-CoV-2 causes an early and specific
dysfunction of the kidney proximal tubule (PT), characterized by low molecular
weight (LMW) proteinuria, neutral aminoaciduria, and defective handling of uric
acid and phosphate. ACE2 receptor for SARS-CoV-2 is highly expressed in the PT
cells.
67% had elevated urinary
levels of β2-microglobulin, 85% had a urinary protein to creatinine ratio
(UPCR) >0.2 g/g, and 98% had a urinary albumin to protein ratio (UAPR)
<0.5.
Electrophoresis of urine samples from these patients evidenced
multiple protein bands below 70 kDa (LMW proteinuria), which included the
vitamin D-binding protein (DBP) and Clara cell secretory protein (CC16).
47% and 56% of the patients were reported to have hypouricemia
and/or hypophosphatemia, respectively.
Defective tubular handling of uric acid (hypouricemia with
inappropriate uricosuria; FEUA >10%) was found in 46% of the
cohort. Meanwhile, hypophosphatemia with inappropriate phosphaturia (FEP >20%)
was observed in 19%.
Aminoaciduria was detected in 46% of patients and was restricted
to neutral amino acids.
Further, the authors noted that PT dysfunction was independent
of pre-existing comorbidities, glomerular proteinuria, nephrotoxic medications
or viral load among the cohort.
During a median follow-up of 44 days 39% of patients required
invasive mechanical ventilation, 29% died, 22% developed AKI and 4% required
kidney replacement therapy. Hypouricemia with inappropriate uricosuria was
found to be independently associated with disease severity and with a
significant increase in the risk of respiratory failure requiring invasive
mechanical ventilation
PT dysfunction develops in a subset of patients with COVID-19
and is characterized by LMW proteinuria, hypophosphatemia and hypouricemia due
to inappropriate urinary loss of phosphate and uric acid, and neutral
aminoaciduria
Hypouricemia was common and associated with poor outcome in
patients with SARS.
Potential mechanisms linking PT dysfunction and respiratory
failure may include the loss of important solutes, including uric acid, which
may affect defense against oxidative stress and respiratory function
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