190 CMAAO CORONA FACTS and MYTH COVID CDC Immunity Three Months
Dr K Aggarwal
1056: Second Sero-survey suggests 28% in city have antibodies
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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