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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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Pandemic has taken a toll on childrens’ mental health

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Since last April, hospital emergency rooms across the United States have seen a sustained surge in visits related to the mental health of school-aged kids, a new report reveals.

The findings suggest the COVID-19 pandemic is taking a toll on children because of disruptions to their everyday life, anxiety about illness and social isolation.

That conclusion comes from a U.S. Centers for Disease Control and Prevention review of data on hospitals in 47 states. Those hospitals account for nearly three-quarters of emergency department visits nationwide.

The study tracked emergency visits involving children under age 18 who sought care for a mental health issue between Jan. 1 and Oct. 17, 2020.

“Our study looked at a composite group of mental health concerns that included conditions that are likely to increase during and after a public health emergency, such as stress, anxiety, acute post-traumatic stress disorder and panic,” said lead author Rebecca Leeb, a health scientist at the CDC in Atlanta who is part of its COVID-19 Response Team.

“We found that from March through October, the proportion of mental health-related emergency department visits increased 24% for children aged 5 to 11, and 31% among teenagers aged 12 to 17 years, compared to 2019,” Leeb said.

Pediatric mental health visits actually dropped off dramatically from mid-March to mid-April, when stay-at-home orders were in effect in much of the country. Since then, however, such visits have steadily increased, according to the report.

But Leeb said interpreting the numbers is not straightforward.

On the one hand, she said even the large jumps seen in the report likely underestimate the total number of pediatric mental health emergencies. “Many mental health care encounters occur outside of emergency departments,” Leeb explained.

But additional research indicates emergency department visits as a whole dropped significantly between January and October. And that, Leeb said, might mean that “the relative proportion of emergency department visits for children’s mental health-related concerns may be inflated.”

Regardless, Leeb said the findings show that many kids’ mental health was sufficiently concerning to prompt ER visits at a time when the public was being discouraged from using emergency departments for anything but the most critical care.

As such, the findings “highlight the importance of continuing to monitor children’s mental health during the pandemic to ensure access to mental health services during public health crises,” Leeb said.

The study did not set out to identify specific reasons for emergency visits and Leeb said figuring that out requires more study.

But past research shows that the lost sense of safety and disruption to daily living that often accompanies disasters is a common trigger for stress. And that stress, in turn, can lead to isolation and trigger mental health emergencies, Leeb said.

This is not surprising, according to psychologist Lynn Bufka, senior director for practice, research and policy at the American Psychological Association.

“These are stressful times for many and stress can exacerbate mental health concerns,” Bufka noted. “Previous research indicates that a portion of children do have adverse outcomes from traumatic events, and this pandemic is no different.”

Bufka pointed to the wholesale uprooting of kids’ routines and structure, both in terms of school and socializing.

“Children’s play is one way children explore and understand their world, so not being able to play with friends gives them fewer outlets for fun, but also just fewer general opportunities to cope and explore,” she explained.

Kids may also pick up on parents’ stress, which can magnify their own fears.

“All of this has an impact on children and how they understand their world and interpret the events around them,” Bufka said. Some kids adapt more easily; others will struggle. For youngsters with existing mental health problems, the current stresses will add to them.

But parents and other adults can do a lot to support kids and help those who are struggling.

On that front, Leeb advised parents to foster a supportive environment and learn about behavior that signals kids are under mounting stress. The CDC has a number of helpful resources, she said, including an online primer on talking with your child about the coronavirus.

Leeb and her colleagues published their findings in the Nov. 13 issue of the CDC’s Morbidity and Mortality Weekly Report.

More information

Get tips on talking with your child about coronavirus at the U.S. Centers for Disease Control and Prevention.

Copyright 2020 HealthDay. All rights reserved.



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Moderna says data show COVID-19 vaccine almost 95% effective

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Nov. 16 (UPI) — The COVID-19 vaccine under development by U.S. biotech firm Moderna is 94.5% effective in preventing infection, according to interim data the company published Monday.

Moderna said early analysis from its late-stage “COVE” clinical trial for its mRNA-1273 vaccine candidate was based on nearly 100 COVID-19 cases.

“This is a pivotal moment in the development of our COVID-19 vaccine candidate,” Moderna CEO Stephane Bancel said in a statement. “Since early January, we have chased this virus with the intent to protect as many people around the world as possible. All along, we have known that each day matters.

“This positive interim analysis from our Phase 3 study has given us the first clinical validation that our vaccine can prevent COVID-19 disease, including severe disease.”

Moderna said its COVE trial has found no serious side effects from the mRNA-1273 vaccine.

Bancel said the company will apply for emergency use authorization from the Food and Drug Administration to distribute the vaccine once it finishes compiling safety data later this month.

“These are obviously very exciting results,” Dr. Anthony Fauci, the nation’s top infectious diseases expert, said Monday. “It’s just as good as it gets — 94.5% is truly outstanding.”

Moderna’s results are similar to those published last week by drugmaker Pfizer, which said its vaccine has shown to be about 90% effective.

Other vaccines are being tested in late-stage trials by Johnson & Johnson, AstraZeneca and Novavax.

Fauci said last week a vaccine could be available to the most at-risk populations before the end of the year.



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Experimental herpes vaccine shows promise in lab trials

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Scientists are reporting early success with an experimental herpes vaccine that uses a genetically modified version of the virus.

The gene edit prevents the virus from performing its normal evasive maneuver: hiding out in nervous system cells in order to elude the immune system.

So far, the vaccine has only been tested in lab animals. But scientists hope the genetic tweak will eventually allow the vaccine to succeed where past ones have failed.

The target is herpes simplex virus, or HSV, which in humans includes HSV-1 and HSV-2. Both can cause genital herpes, though HSV-1 is best known for triggering cold sores.

Globally, a half-billion people aged 15 to 49 have a genital herpes infection, according to the World Health Organization.

Those figures alone show there is a “huge need” for a vaccine, said Gary Pickard, one of the researchers on the new study.

But beyond that, once HSV invades the body, it’s there to stay, said Pickard, a professor of neuroscience at the University of Nebraska-Lincoln School of Veterinary Medicine and Biomedical Sciences.

To evade the immune system, the virus works its way into nerve cells and remains there in a dormant state. It can periodically become active again, traveling to the skin and causing sores and other symptoms.

In addition to those flare-ups, HSV infection can sometimes lead to complications. Pregnant women can, rarely, pass it to their newborns, who can become very sick or die, said Terri Warren, a registered nurse and medical advisor to the American Sexual Health Association.

Genital sores, and active HSV infection, also leave people more vulnerable to contracting HIV.

“In some places,” Warren said, “it accounts for many cases of HIV.”

Genital herpes also exacts a psychological toll, she explained, because it’s a lifelong infection that people can transmit to their partners, even when they are symptom-free.

That’s why researchers have been trying for years to create a preventive vaccine — with no success thus far.

As Pickard explained, one issue is that some candidate vaccines use only a subset of HSV components, or antigens, to try to generate an immune response. And that may not be enough: One vaccine with that design failed to prevent HSV-2 infection in a clinical trial involving thousands of young women.

Some other experimental vaccines have used a live, weakened form of HSV, but have run into similar issues.

“They’ve essentially made the virus so ‘sick’ that it can’t illicit a strong immune response,” Pickard said.

The new approach, recently described in the journal npj Vaccines, might circumvent those problems.

For the study, the researchers tested a vaccine made with a live, weakened form of HSV-1 that has a key genetic edit: It prevents the virus from advancing into the nervous system, while allowing it to replicate outside nerve tissue, to draw an immune response.

In lab experiments with guinea pigs, the tactic showed promise.

Of 12 animals given skin injections of the vaccine, only one developed sores after being exposed to HSV-2. In contrast, sores cropped up in 10 of 12 guinea pigs given no vaccine, and in five of 12 given the vaccine that failed in the earlier, human clinical trial.

In addition, the modified vaccine cut the viral shedding period by more than half, from 29 days to about 13. That’s important, Pickard said, because in humans it’s the viral shedding that can transmit the infection, even when there are no sores present.

“The findings on viral shedding are positive,” agreed Warren, who was not involved in the research.

She said a big question is whether a version of the vaccine that uses HSV-2 — rather than HSV-1 — can be shown effective in animals.

The researchers are working on that. Pickard said they are encouraged by the fact that the current vaccine showed “cross-protection” against HSV-2: If anything, they anticipate that an HSV-2 version will be more effective.

The road to an approved vaccine, however, is a long and very expensive one.

The hope is to have a vaccine ready for initial, phase I human testing within a few years, according to Pickard.

More information

The American Sexual Health Association has more on herpes.

Copyright 2020 HealthDay. All rights reserved.



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