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Obese children 3 times more likely to need a ventilator with COVID-19, study finds



June 3 (UPI) — Obese children with COVID-19 might be at increased risk for a serious case, an analysis of hospitalized patients in New York City published Wednesday by JAMA Pediatrics said.

Children age 2 or older who met the criteria for obesity were three times more likely to require a ventilator to treat their disease than those who had a healthy weight, the study found.

However, severe disease caused by the new coronavirus, SARS-CoV-2, remains relatively rare in young people, a similar study out of Wuhan, China — also published Wednesday, by JAMA Network Open — has found.

“While most children and adolescents have mild disease, a small percentage with underlying conditions have severe respiratory disease, which is associated with higher levels of inflammation,” Dr. Philip Zachariah, co-author of the New York City study, told UPI.

“Even within young people, there is a spectrum of disease, both in terms of presentation and severity,” said Zachariah, who is an assistant professor of pediatrics at Columbia University Medical Center.

Both studies echoed the findings of a study published earlier this week in the journal Pediatrics, which indicated that the vast majority of children with COVID-19 — more than 90 percent — experience mild to moderate illness, with few if any symptoms.

However, it is the “minority who are likely to worsen” who should be the focus of future research to learn the effects of COVID-19 on children, Zachariah said.

For their research, he and his colleagues reviewed data on 50 COVID-19 patients at a children’s hospital in New York City. In all, 27 of the patients were boys and 25 were Hispanic, the authors said.

The estimated time between symptom onset and hospital admission was two days, according to the authors. Overall, 40 had fever and 32 had respiratory symptoms, but three only developed gastrointestinal problems, they said.

Obesity was the most prevalent underlying health condition among the 50 patients, affecting 11 of them, and six of these children required ventilation, the authors said. Among all 50 patients, 16 required respiratory support, including nine who needed mechanical ventilation, they said.

However, six of the nine children age 2 or older who were obese needed ventilator support, compared to only one of five non-obese children, the authors reported.

Children with severe disease had significantly higher levels of biomarkers — or signs — of inflammation, including C-reactive protein, procalcitonin, interleukin 6, ferritin and D-dime, according to the authors.

Four of the patients in the study had measurable levels of the virus in their systems for up to 27 days, based on test findings, the authors said.

Similarly, the study out of Wuhan, which included 157 children with COVID-19, found elevated levels of several inflammatory biomarkers — including interleukin 10 — and reduced white blood cell counts in those with moderate or severe disease.

In all, six of the children developed severe disease and three became critically ill, the Chinese authors said, adding that two of the three critically ill patients had cancer.

Where the studies differed, however, was in their respective findings on the age of children more adversely affected by COVID-19. In China, children with moderate disease were younger than those with mild cases — 66 months versus 84 months.

Conversely, in the New York City study, there were 14 infants — children 1 year old or younger, and none of them developed severe disease.

“[We] did not find severe COVID-19 being associated with infancy, which has been reported previously,” Zachariah said.

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Antidepressant might help prevent severe COVID-19



The antidepressant drug fluvoxamine — best known by the brand name Luvox — may help prevent serious illness in COVID-19 patients who aren’t yet hospitalized, a new study finds.

The study included 152 patients infected with mild-to-moderate COVID-19. Of those, 80 took fluvoxamine and 72 took a placebo for 15 days.

By the end of that time, none of the patients who took the drug had seen their infection progress to serious illness, compared with six (8.3%) of the patients who took the placebo, according to researchers at Washington University School of Medicine in St. Louis.

“The patients who took fluvoxamine did not develop serious breathing difficulties or require hospitalization for problems with lung function,” said first author Dr. Eric Lenze, professor of psychiatry.

“Most investigational treatments for COVID-19 have been aimed at the very sickest patients, but it’s also important to find therapies that prevent patients from getting sick enough to require supplemental oxygen or to have to go to the hospital. Our study suggests fluvoxamine may help fill that niche,” Lenze noted in a university news release.

Fluvoxamine — widely used to treat depression, obsessive-compulsive disorder and social anxiety disorder — is a type of drug called a selective serotonin-reuptake inhibitor (SSRI). This class of drugs also includes medicines such as Prozac, Zoloft and Celexa.

But unlike other SSRIs, fluvoxamine has a strong interaction with a protein called the sigma-1 receptor, which helps regulate the body’s inflammatory response.

“There are several ways this drug might work to help COVID-19 patients, but we think it most likely may be interacting with the sigma-1 receptor to reduce the production of inflammatory molecules,” explained study senior author Dr. Angela Reiersen, associate professor of psychiatry.

“Past research has demonstrated that fluvoxamine can reduce inflammation in animal models of sepsis, and it may be doing something similar in our patients,” she said in the release.

By reducing inflammation, fluvoxamine may prevent a hyperactive immune response in COVID-19 patients. That, in turn, may decrease their risk of serious illness and death, Reiersen said.

“Our goal is to help patients who are initially well enough to be at home and to prevent them from getting sick enough to be hospitalized,” Dr. Caline Mattar, assistant professor of medicine in the Division of Infectious Diseases, said in the release. “What we’ve seen so far suggests that fluvoxamine may be an important tool in achieving that goal.”

Dr. Amesh Adalja is a senior scholar at the Johns Hopkins Center for Health Security in Baltimore. He wasn’t involved in the study, but said the research is “notable not only because of its positive outcome — we desperately need a medication that keeps COVID patients out of the hospital — but also because of the manner in which it was conducted.”

But Adalja stressed that a larger trial is needed “to see if the promising findings hold up.”

The researchers said they plan to begin such a study in the next few weeks and it will include patients from across the United States.

The preliminary study was published online Nov. 12 in the Journal of the American Medical Association.

More information

For more on COVID-19, go to the U.S. Centers for Disease Control and Prevention.

SOURCES: Amesh Adalja, M.D., senior scholar, Johns Hopkins Center for Health Security, Baltimore; Washington University in St. Louis, news release, Nov. 12, 2020

Copyright 2020 HealthDay. All rights reserved.

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Survey: 40% in U.S. planning large gatherings for holidays despite COVID-19 warnings



Nov. 12 (UPI) — Nearly 40% of U.S. residents plan to participate in gatherings of 10 or more people this holiday season despite concerns over the spread of COVID-19, according to the findings of a survey released Thursday by Ohio State University.

In addition, one-third of respondents said they wouldn’t ask attendees at holiday parties with family or friends to wear masks, and just over 25% indicated that they wouldn’t practice social distancing, the data showed.

“We’re going to look back at what happened during this holiday season and ask ourselves, ‘Were we part of the solution or were we part of the problem?'” Dr. Iahn Gonsenhauser, part of the team that conducted the survey, said in a statement.

“When you’re gathered together around the table, engaged in conversation, sitting less than 6 feet apart with your masks down, even in a small group, that’s when the spread of this virus can really happen,” said Gonsenhauser, chief quality and patient safety officer at Ohio State University Wexner Medical Center.

Researchers at Ohio State surveyed more than 2,000 U.S. residents on their holiday plans in the context of the COVID-19 pandemic.

As of Thursday afternoon, nearly 10.5 million people nationally have been sickened by the virus, and more than 240,000 have died, according to figures from Johns Hopkins University.

In recent weeks, federal, state and local public health officials have advised against traveling or partaking in large social gatherings as the holiday season approaches to limit the risk of spreading the new coronavirus to vulnerable loved ones.

At the very least, they’ve asked that gatherings not happen without wearing a mask and practicing social distancing, or staying 6 feet apart.

Those at risk for severe COVID-19 include the elderly, as well as those with diabetes, heart disease and high blood pressure, all of which are common across the United States, according to the Centers for Disease Control and Prevention.

Still, 38% of respondents to the Ohio State survey indicated they would host or attend a gathering with 10 or more people during the holidays and 33% would not ask others to wear masks, the researchers said.

However, 73% of respondents said they would practice social distancing during the holidays and 79% suggested that they would celebrate or gather only with people with whom they live, the data showed.

Just over 80% indicated that they would ask family and friends invited to events not to come if they had symptoms of COVID-19.

“If you have someone in your household who’s high risk and you’re in a low incidence area, you’re going to want to think twice about having a celebration where people are coming from an area where there’s a lot of virus in the community,” Gonsenhauser said.

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Healthy diet, exercise good for heart regardless of medication use



No matter how many medications you take, eating a healthy diet, not smoking and getting plenty of exercise will help keep you alive, a new study finds.

“We’ve long known about the benefits of leading a healthy lifestyle. The results from our study underscore the importance of each person’s ability to improve their health through lifestyle changes even if they are dealing with multiple health issues and taking multiple prescription medications,” said researcher Neil Kelly. He’s a medical student at Weill Cornell Medicine of Cornell University in New York City.

For the study, Kelly’s team collected data on more than 20,000 people who took part in a study on racial differences in stroke.

At the start of the study, 44% of participants were taking four or fewer prescription medications, 39% were taking five to nine, and 17% were taking 10 or more medications.

After about 10 years, the researchers found that a healthy lifestyle reduced the risk of death during the study period regardless of the number of medications a person was taking, and the more healthy lifestyle habits one had, the lower the risk of death.

The findings were scheduled for presentation at the American Heart Association’s virtual annual meeting, Nov. 13 to 17. Such research should be considered preliminary until published in a peer-reviewed journal.

“It’s especially important for health care professionals to counsel patients and develop interventions that can maximize healthy lifestyle behaviors, even among patients with several prescription medications,” Kelly said in an AHA news release.

“It’s important for the public to understand that there is never a bad time to adopt healthy behaviors. These can range from eating a healthier diet to taking a daily walk in their neighborhood,” he added. “A healthier lifestyle buys more time.”

More information

For more on a healthy lifestyle, head to the American Heart Association.

Copyright 2020 HealthDay. All rights reserved.

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