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Experts: Asthma caused by allergies doesn’t increase risk for severe COVID-19

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Everyone agrees about the good news — folks whose asthma is spurred on by allergies don’t appear to have an increased risk of life-threatening illness if they contract COVID-19.

“Asthma has not risen as one of the top comorbid diseases for worse COVID-19 outcomes,” said Dr. Sandhya Khurana, director of the Mary Parkes Center for Asthma, Allergy and Pulmonary Care at the University of Rochester Medical Center in New York.

“We always worry with asthma and viral infections, because they seem to trigger asthma exacerbation unreasonably,” Khurana said. “But what we’ve seen so far is reassuring.”

But debate continues to swirl regarding the potential severity of COVID-19 infection in people with non-allergic asthma.

Some studies have suggested that people who have asthma caused by something other than allergies — exercise, stress, air pollution, weather conditions — might have an increased risk of severe COVID-19.

For example, Harvard researchers found that having non-allergic asthma increased the risk of severe COVID-19 by as much as 48%. That conclusion was based on data from 65,000 asthma sufferers presented in the June issue of the Journal of Allergy and Clinical Immunology.

“For those people, I think being more cautious would be good for them,” said senior researcher Liming Liang, an associate professor of statistical genetics at the Harvard T.H. Chan School of Public Health in Boston. “I think the next wave is coming. We’ve got to be more cautious.”

But other experts note that the data involving COVID-19 and non-allergic asthma sufferers is very limited, and any conclusions that these folks are at higher risk of severe infection could be flawed.

Their asthma could be caused by other lung ailments that are associated with more serious cases of COVID-19, for instance, said Dr. Mitchell Grayson, chief of allergy and immunology at Nationwide Children’s Hospital in Columbus, Ohio.

“There have been several studies that have shown that COPD does increase your risk of more severe disease,” he said. “I don’t think these studies have done a good job of excluding COPD in these patients.”

Grayson agrees with Khurana that in the early days of the COVID-19 pandemic, there was much concern that asthma could be a risk factor — a reasonable suspicion, given that the coronavirus attacks the lungs.

But everything that came out of the initial epidemic in China suggested that asthma was not a risk factor for life-threatening COVID-19, Grayson said, and the data continued to confirm that as the coronavirus spread across the globe.

“It’s not there in the data. If it is there, it’s extremely small risk. It’s nothing I can see,” he said.

Researchers have speculated that people with allergy-driven asthma might have some protection against COVID-19, due to the way the coronavirus infects the body.

The coronavirus that causes COVID-19 enters lung cells by engaging with a type of protein on their surface called an ACE2 receptor, Khurana said.

“In the setting of an allergic type of inflammation, the expression of the ACE2 receptor appears to be downregulated. It appears to be lower. There’s not as much receptor,” she said.

Because there aren’t as many ACE2 receptors available, people with allergic asthma might not be as vulnerable to severe infection, Khurana said. This theory also could help explain why other chronic diseases appear to increase COVID-19 risk, she added.

“Patients in conditions like diabetes or hypertension, this receptor expression is increased,” Khurana said. “That’s a possible reason why those comorbid diseases are at especially high risk for this infection.”

But that only explains why allergic asthma isn’t a major risk factor for severe COVID-19, Grayson said. It doesn’t explain why some studies are finding increased risk among people with non-allergic asthma.

Grayson suspects that the purported link between non-allergic asthma and COVID-19 found in these studies is actually a link between a COVID-19 and a host of different lung ailments, especially COPD.

“There are studies showing that COPD increases your risk of more severe COVID-19, not markedly but a little bit, not to the extent of things like hypertension and diabetes and [being] elderly,” he said. “I’m concerned that what they’re calling non-allergic asthma actually is COPD, which would skew their data.”

In Khurana’s view, more study is needed, particularly prospective studies that track people with different types of asthma prior to COVID-19 infection.

“So far, we just don’t know enough to make any conclusions. I think we’re still scratching the surface here and still have a lot to learn,” she said.

In the meantime, it would pay for everyone to protect themselves, Khurana added.

“It’s good practice to observe the recommended guidance on hand hygiene and social distancing and masking and avoiding any situation where you could be exposed, even though it’s obviously welcome to see that allergic asthma is not as high-risk as some of the other comorbid diseases,” Khurana said.

More information

The American Academy of Allergy, Asthma and Immunology has more about COVID-19 myths.

Copyright 2020 HealthDay. All rights reserved.



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Survey reinforces Americans’ apprehension about rushed COVID-19 vaccine

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Oct. 9 (UPI) — Nearly 40% of Americans say they won’t get vaccinated against COVID-19 even if a shot becomes available, according to a survey released Friday by consulting firm Children’s Health Defense.

In the survey of more than 1,000 “likely voters,” just over half said they planned to receive the vaccine, while the rest remain undecided.

Just under 30% of respondents said they had concerns regarding the safety of any new vaccine against the coronavirus, with most suggesting the research and development process may have been “rushed” or that the vaccine “needs more testing,” the organization said.

“The growing skepticism about the COVID vaccine is the rational response of a public now paying more attention to how this sausage is getting made,” Robert F. Kennedy Jr., founder and chairman of Children’s Health Defense, said in a statement.

Children’s Health Defense, which is known for it’s anti-vaccine activism, commissioned John Zogby Strategies to conduct the survey. The firm specializes in research for private companies, as well as U.S. government agencies.

Trials of several potential vaccines against COVID-19 are ongoing, and Trump administration officials have said they expect initial doses to be available before the end of the year.

However, the U.S. Food and Drug Administration said earlier this week that it won’t approve a vaccine until sufficient safety data exists, which may impact that timeline.

The Children’s Health Defense survey included 1,006 respondents, all age 18 years and older and registered voters, the organization said.

The survey was launched hours after President Donald Trump was admitted to Walter Reed National Military Medical Center for COVID-19 treatment, Kennedy said.

Although 51% of respondents said they planned to get the vaccine after it’s introduced, 36% said they wouldn’t, while the rest were undecided, the data showed.

Although Children’s Health Defense is known primarily for its anti-vaccine stance, other surveys of Americans’ interest in receiving inoculations against COVID-19 have had similar findings.

In August, a Gallup poll found that 35% of Americans would refuse the vaccine, with those who identify as Republicans most skeptical.

Still, more than 65% of respondents in that survey said they would obtain the vaccine, the data showed.

A separate survey conducted earlier this year by the University of Minnesota and Johns Hopkins University found that most Americans believe front-line health workers and other at-risk groups should be given priority when or if a vaccine is made available.



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Study: Kids’ hospitalizations accompany rising unemployment rates

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COVID-19 has led to widespread job loss in the United States. And now a new study reports that when unemployment rates rise, so do hospitalizations of children.

For the study, researchers analyzed 12 years of data — 2002 to 2014 — from 14 states. They found that for every 1% increase in unemployment, there was a 2% increase in child hospitalizations for all causes, among them diabetes and poisonings.

Specifically, every 1% bump in unemployment was associated with a 5% increase in hospitalizations for substance abuse and a 4% jump for diabetes. The researchers also found a 2% increase for poisoning and burns, and a 2% rise for children with medical complexity — a high need for prescriptions, medical equipment or services.

For children with diabetes and other forms of medical complexity, reduced family income could mean they’re less likely to receive medical services. This could raise their risk of hospitalizations, the study authors suggested.

It’s also possible that poor housing conditions brought on by slimmer wallets could increase children’s risk of poisonings and burns. And higher household stress due to unemployment might increase alcohol and drug use.

Further research is needed to understand how to prevent declining health in children during economic downturns, said study author Dr. Jeffrey Colvin, of Children’s Mercy Hospital in Kansas City, Mo., and his colleagues.

The U.S. National Institutes of Health-funded study was published in the October issue of the journal Health Affairs.

The study relied on data from Colorado, Florida, Iowa, Kentucky, Michigan, Nebraska, New Jersey, New York, North Carolina, Oregon, Rhode Island, Utah, Vermont and Washington.

More information

The U.S. National Library of Medicine has more on children’s health.

Copyright 2020 HealthDay. All rights reserved.



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Researchers confirm coronavirus can infect the eye

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COVID-19 is primarily a respiratory infection, but experts have suspected the virus can also infiltrate the eyes. Now, scientists have more direct evidence of it.

The findings are based on a patient in China who developed an acute glaucoma attack soon after recovering from COVID-19. Her doctors had to perform surgery to treat the condition, and tests of her eye tissue showed evidence of the coronavirus.

The case offers proof that “[the coronavirus] can also infect ocular tissues in addition to the respiratory system,” the doctors reported in the Oct. 8 online edition of the journal JAMA Ophthalmology.

“It’s been suspected that the eyes can be a source of both ‘in’ and ‘out'” for the novel coronavirus, said Dr. Aaron Glatt, a spokesman for the Infectious Diseases Society of America.

That’s why health care workers protect their eyes with goggles or face shields, he noted.

It’s not possible to say whether the patient in this case contracted the coronavirus via her eyes, according to Glatt. But that is a possibility — whether through viral particles in the air or by touching her eyes with a virus-contaminated hand, he said.

Another big unknown is whether any lingering virus in patients’ eye tissue will cause problems.

According to Dr. Grace Richter, an ophthalmologist at the University of Southern California’s Roski Eye Institute in Los Angeles, “It’s too early to know what having this virus floating around in the eye means for ocular health.”

At this point, Richter said, limited eye problems have been seen with COVID-19: A small number of patients develop conjunctivitis, or “pink eye,” where the white part of the eye and inside of the eyelid become swollen, red and itchy.

The patient in this case suffered acute angle-closure glaucoma — a serious condition in which pressure in the eyes suddenly rises due to fluid buildup. It requires prompt treatment to relieve the pressure, sometimes with surgery to restore the eye’s normal fluid movement.

Richter was doubtful the coronavirus directly caused the eye complication. In general, certain anatomical features of the eye make some people vulnerable to acute angle-closure glaucoma, and it can be triggered by medications, she explained.

Richter speculated that since the patient was hospitalized and likely received various drugs, that might have been the cause.

That is possible, agreed Dr. Sonal Tuli, a clinical spokeswoman for the American Academy of Ophthalmology and chairwoman of ophthalmology at the University of Florida College of Medicine, in Gainesville.

Tuli said the patient’s case is “interesting,” but leaves open a number of questions. One is whether the virus present in the eye tissue is actually infectious.

The patient was a 64-year-old woman who was hospitalized for COVID-19 on Jan. 31. Eighteen days later, her symptoms had fully resolved, and throat swabs turned up negative for the coronavirus.

About a week later, though, she developed pain and vision loss in one eye, and then in her other eye a few days afterward, according to the report by Dr. Ying Yan and colleagues at the General Hospital of the Central Theater Command in Wuhan, China.

The patient landed in the hospital again, where she was diagnosed with acute angle-closure glaucoma and cataract. Medication failed to bring down her eye pressure, so her doctors performed surgery — taking tissue samples in the process.

Tests of those samples turned up evidence that the coronavirus had invaded the eye tissues, Yan’s team reported.

While it’s not clear how the virus got into the patient’s eyes, the experts agreed the case underscores the importance of eye protection. For health care providers, that means goggles and face shields for the average person, it’s regular hand-washing and keeping the hands away from the eyes.

“I think people don’t realize how often they touch their eyes,” Tuli said.

That advice will reduce the chance of any virus, including cold and flu bugs, from coming into contact with the eyes, she noted.

While that may be enough in most cases, people caring for someone with COVID-19 at home may want to be extra cautious, Tuli suggested. Wearing eye protection in addition to a mask is a “good idea,” she said.

More information

The American Academy of Ophthalmology has more on coronavirus and eye health.

Copyright 2020 HealthDay. All rights reserved.



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