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Older people with COVID-19 who call 911 don’t have ‘classic’ symptoms, study finds

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July 8 (UPI) — A study published Wednesday urges emergency medical workers to take greater care in treating possible cases of COVID-19, as many patients don’t exhibit the conventional symptoms.

The analysis showed that just over half of adults infected with coronavirus in King County, Wash. in February and March who called 911, received care from rescuers and went to an emergency room had a fever or breathing difficulties.

“Instead, there was a wide range of presenting complaints,” Dr. Tom Rea, who co-authored the JAMA Network Open study, told UPI.

Forty percent reported severe fatigue, nearly 28 percent had signs of “altered mental status” — or confusion — and up to 10 percent experienced severe nausea and vomiting, the researchers said.

“Hence, there needs to be a wide net of suspicion for COVID,” particularly among older adults, said Rea, a professor of medicine at the University of Washington.

The findings are based on an analysis of 775 confirmed cases of COVID-19 in King County, which includes Seattle, and was one of the early outbreak hot spots in the United States. The cases were reported between Feb. 1 and March 18.

Researchers said 124 — or 16 percent — of the cases included an EMS response. Patients who called 911 and received EMS care were roughly 75 years old, and 47 — 38 percent — had three or more chronic health conditions, with high blood pressure and heart disease the most common.

“They can present in a variety of ways, many of them atypical,” Rea said. “EMS [needs] to be on alert and assure they are protected and that hospitals are prepared to test this group even when they do not have conventional symptoms.”

Fifty-seven — 46 percent — of the patients in the study lived in a long-term care facility, though researchers said nonspecific signs and symptoms of COVID-19 were also widely seen in others.

Just over 16 percent required breathing assistance — with CPAP or another device — when EMS arrived.

As of June 1, 65 — 52 percent — of the patients in the study had died, researchers said.



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

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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

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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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Bacteria in lungs may play role in cancer development, study says

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Lung cancer patients who harbor certain bacteria in the airways may have a poorer prognosis, a new study finds, adding to evidence that the body’s “microbiome” may play a role in cancer patients’ outlook.

The microbiome refers to the trillions of bacteria and other microbes that naturally dwell in the body. Research in recent years has been revealing how important those bugs are to the body’s normal functions, including immune system defenses.

When it comes to cancer, studies have hinted that the microbiome can influence tumor progression, and patients’ likelihood of responding to certain treatments.

For example, a number of cancers can be treated with immunotherapy — various approaches to boosting the immune system’s natural tumor-fighting capacity. Research has found that patients who respond well to immunotherapies tend to have a different makeup in the gut microbiome, compared to patients who do not respond.

The new study, published this week in Cancer Discovery, took a different view. Instead of focusing on the gut microbiome, researchers analyzed lung microbes of patients with newly diagnosed lung cancer.

In microbiome research, “the lung has really been ignored,” said lead researcher Dr. Leopoldo Segal, director of the Lung Microbiome Program and an associate professor at New York University Grossman School of Medicine in New York City.

Traditionally, he explained, the lungs were believed to be “sterile.” But recent research has shown that even in healthy people, the lungs can harbor low amounts of bacteria — drawn in from the air or the mouth.

Segal’s team wanted to see whether lung bacteria corresponded to lung cancer patients’ prognosis.

Looking at tissue samples from 83 patients, the researchers found that those with advanced-stage cancer carried more microbes than patients in the early stage of disease.

And when patients did have “enrichment” with certain bacteria types, their odds of survival were lower — even those with earlier-stage cancer.

Specifically, patients harboring Veillonella, Prevotella and Streptococcus bacteria had a worse prognosis. They also showed signs of an inflammatory immune response that, based on past research, may worsen lung cancer patients’ outlook.

None of that proves the bacteria, themselves, were to blame, Segal said. The cancer itself might make the lungs more “receptive” to being colonized with bacteria.

So the researchers turned to lab mice. They transferred Veillonella bacteria into mice with lung cancer and found that the microbes revved up “bad” inflammation, fed tumor growth and shortened the animals’ survival.

That suggests lung bacteria might modulate the immune response in a way that affects lung cancer progression, according to Segal.

But the microbiome is complicated, and it’s hard to draw conclusions from mouse findings, according to Dr. Thomas Marron of Mount Sinai’s Tisch Cancer Institute in New York City.

Right now, he said, there is a “huge interest” in understanding the microbiome’s influence in cancer.

“Studies like this are really interesting,” said Marron, who was not involved with the research, “but we’re probably a few decades away from being able to alter the microbiome to treat cancer.”

Individuals vary in their microbiome makeup, and that’s determined by things like genetics and the immune system, Marron explained. So even if the body’s microbial communities directly affect cancer prognosis, he said, it will be a long time before researchers can turn that into therapy.

“We still don’t know how we could effectively target the microbiome,” Marron said.

He pointed to one question from the new findings: Is there any link between the lung microbiome and patients’ likelihood of responding to immunotherapy?

Segal said his team plans to study that.

Dr. John Heymach chairs thoracic/head and neck medical oncology at M.D. Anderson Cancer Center in Houston. He called the findings “a compelling starting point,” but also emphasized the long research road ahead.

“At this point, we’re not ready to directly act on this in the clinic, by either trying to kill ‘bad’ bacteria, or add back ‘good’ bacteria,” said Heymach, who was not part of the study.

So far, he noted, studies have reached different conclusions as to exactly which types of bacteria are related to better cancer outcomes — which might be due to differences in how studies look for the microbes.

And like Marron, Heymach pointed to the microbiome’s complexity: It generally differs from one large population to the next and among individuals — based on numerous factors.

Still, Heymach said the recent “explosion” in microbiome research could eventually lead to applications in cancer treatment. Besides the possibility of altering the microbiome, he said doctors might be able to use patients’ microbiome makeup as a “biomarker” of their risk of progression.

More information

The American Cancer Society has more on cancer immunotherapy.

Copyright 2020 HealthDay. All rights reserved.



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