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

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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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Almost 14 million U.S. adults vape, with use rising fastest in young

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The number of Americans using electronic cigarettes is soaring, especially among youth, a new study finds.

Nearly 14 million U.S. adults vaped in 2018, up from just over 11 million adults in 2016. The increase was seen in all socioeconomic groups, the researchers found.

“An increasing number of individuals are using e-cigarettes, especially in the younger age groups, which suggests that more individuals are becoming addicted to e-cigarettes rather than just experimenting with them, making the increased uptake among tobacco-naive individuals even more concerning,” said lead researcher Dr. Olufunmilayo Obisesan. She’s a postdoctoral fellow at Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, in Baltimore.

“The increase in e-cigarette use among individuals with other health-risk behaviors is also concerning, particularly in light of the outbreak of e-cigarette or vaping use-associated lung injuries that has been linked to the vaping of tetrahydrocannabinoids [THC],” she said. THC is the main mind-altering ingredient found in marijuana.

Between 2016 and 2018, young adults aged 18 to 24 years old were the fastest-growing population to start using e-cigarettes. E-cigarette use in that age group increased from 9% in 2016 to 15% in 2018, and use among students increased from 6% in 2016 to 12% in 2018.

E-cigarette use even increased among people who had never smoked traditional cigarettes — from more than 1.4% in 2016 to 2.3% in 2018, the findings showed.

Also, people who were into other risky behaviors — such as drinking alcohol and smoking marijuana — were more likely to use e-cigarettes, the study authors said.

For the study, the researchers collected data on more than one million Americans who took part in the Behavioral Risk Factor Surveillance System for 2016 to 2018.

“Increase in e-cigarette use among adults in the U.S., particularly daily use, is reflective of the addictive potential of e-cigarettes,” Obisesan said. “This is very important to note, particularly for the youth and for individuals who currently use or are considering using them as a means of experimentation.”

The report was published online Sept. 8 in JAMA Internal Medicine.

Stanton Glantz, a professor of medicine at the Center for Tobacco Control, Research and Education at the University of California, San Francisco, said the increase in e-cigarette use is troubling because the health risks of e-cigarettes are similar to the risks linked to traditional cigarettes.

“I think there’s some things that are pretty clear now — one is in terms of lung disease. E-cigarettes are about as bad as cigarettes — you’re still breathing in ultrafine particles, heavy metals and flavors that have high pulmonary toxicity,” he said.

Glantz also pointed out that the damage e-cigarettes can cause in the lungs may also make COVID-19 infections more severe.

E-cigarette use has also been tied to an increased risk of heart disease, and in animal experiments, to cancer and DNA damage, he added.

The bottom line for Glantz is that e-cigarettes aren’t safe alternatives to regular cigarettes and often lead to dual use.

The U.S. Food and Drug Administration has the power to regulate e-cigarettes, and they could actually ban them, Glantz said.

“The FDA can simply say, we’re not going to allow these products to be sold,” he said. “In order to sell e-cigarettes in the United States, you need to have what’s called a marketing order. If the FDA doesn’t grant a marketing order, then the product can’t be sold. If the product can’t be legally sold, that will solve the problem.”

More information

For more on e-cigarettes, head to the U.S. Centers for Disease Control and Prevention.

Copyright 2020 HealthDay. All rights reserved.



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Study: NSAID pain relievers don’t increase risk for severe COVID-19

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Sept. 8 (UPI) — People who use non-steroidal anti-inflammatory drugs, or NSAIDs, to treat pain are not at risk for more severe illness from COVID-19, according to a study published Tuesday by the journal PLOS Medicine.

Among users of NSAID pain relievers like ibuprofen and diclofenac infected with the new coronavirus, nearly 25% needed to be hospitalized, 5% required admission to the intensive care unit and 6.3% died, the data showed.

To compare, for those who did not use these drugs but tested positive for COVID-19, 21% were hospitalized, 5% needed ICU care and 6.1% died.

In the early phases of the pandemic, there were concerns that the use of the painkiller ibuprofen may lead to a more severe course of coronavirus disease, the researchers, from the University of Southern Denmark and Aarhus University Hospital in Denmark, said.

“Considering the available evidence, there is no reason to withdraw well-indicated use of NSAIDs during the pandemic,” they wrote.

“However, the well-established adverse effects of NSAIDs, particularly their renal, gastrointestinal and cardiovascular effects, should always be considered, and NSAIDs should be used in the lowest possible dose for the shortest possible duration for all patients,” they said.

Ibuprofen and other NSAIDs are some of the most commonly used medications in the United States, with an estimated 30 million doses consumed and 70 million prescriptions administered annually, according to the American College of Rheumatology.

For this study, the researchers obtained data on all 9,326 Danish residents who tested positive for COVID-19 between Feb. 27 and April 29, including NSAID use, hospitalization, ICU admission and need for mechanical ventilation and acute renal replacement therapy.

Overall, 248 people — or just under 3% — of the patients included in the analysis had filled a prescription for NSAIDs within 30 days of their positive virus test, according to the researchers.

There was no association between disease severity and NSAID use, the researchers said.

Another study published Aug. 12 had similar findings.



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Low-dose electrical stimulation helps adults with dyslexia read, study finds

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Sept. 8 (UPI) — Electrical stimulation of the brain improves reading accuracy in adults with dyslexia, according to a study published Tuesday by PLOS Biology.

Transcranial alternating current stimulation, a non-invasive procedure that delivers low-dose electricity to the brain over a period of 20 minutes, was found to improve phonological processing — or ability to discern how words sound or are pronounced — and reading accuracy in 15 adults with dyslexia, the researchers said.

The beneficial effect on phonological processing was most pronounced in those individuals who had poor reading skills, while a slightly disruptive effect was observed in very good readers, they said.

Dyslexia, known commonly as a reading disorder, affects up to 10% of the population, and is characterized by lifelong difficulties with written material,” according to the researchers, who are from the University of Geneva in Switzerland.

Although several possible causes have been proposed for dyslexia, the predominant one is a phonological deficit, or a difficulty in processing word sounds, the researchers said.

The phonological deficit in dyslexia is associated with changes in rhythmic or repetitive patterns of electrical activity in the brain, specifically “low-gamma” oscillations, measuring at 30 hertz or volts, in the left auditory cortex, they said.

However, studies have yet to prove that these these oscillations affect a person’s ability to process word sounds and cause dyslexia, the researchers said.

For this study, the researchers applied transcranial alternating current stimulation over the left auditory cortex in 15 adults with dyslexia and 15 fluent readers for 20 minutes.

At a dose of 30 hertz or volts, the approach resulted in significant improvement in reading accuracy in those with dyslexia, the researchers said.

However, the same improvements were not seen following application of a higher, 60-hertz dose, they said.

The results demonstrate for the first time that low-gamma oscillatory activity causes deficits in phonemic processing and may pave the way to non-invasive treatments aimed at normalizing oscillatory function in auditory cortex in people with dyslexia, the researchers said.

They plan “to investigate whether normalizing oscillatory function in very young children could have a long-lasting effect on the organization of the reading system [and] explore even less invasive means of correcting oscillatory activity,” study co-author Silvia Marchesotti, a post-doctural researcher at the University of Geneva, said in a press release.



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