School of Medicine review proposes treatments for COVID-related blood clots
Yale News
Scientists at Yale have synthesized research from around the world to suggest new treatment methods for COVID-19.
A multidisciplinary team of Yale physician scientists, researchers, nursing staff and others have collaborated since early on in the pandemic to figure out why COVID-19 patients are so prone to blood-clotting. Their recent review, published on Nov. 19 in Nature Reviews Cardiology, details how COVID-19 causes blood clots in sick patients and why the disease has been so difficult to treat.
“Blood clotting is a complex process that involves many types of cells in the body including platelets and endothelial cells,” John Hwa, professor of medicine at the Yale Cardiovascular Research Center and one of the review’s senior authors, wrote in an email to the News. “It isn’t often that all components involved are in serious disarray and thus synergizing to promote massive blood clotting. In some ways it’s like ‘a perfect storm’ where all the components are perturbed and are tipped over the edge by COVID-19.”
Hwa said his colleague Hyung Chun, co-author of the review and director of Translational Research at the Yale Pulmonary Vascular Disease Program, contacted him in March when he suspected that endothelial cells, which line the interior surface of blood vessels, might be involved in the pathogenesis of COVID-19.
Alfred Lee, associate professor of Medicine and another author of the review, also reached out to Hwa in March and informed him of potential abnormalities in platelets — cells responsible for blood clotting — that he was observing in COVID-19 patients. The team, which included Lee, Hwa and Chun, expanded those observations into a massive collaborative effort that included many frontline healthcare workers helping with patient treatment.
Platelets and endothelial cells are not usually considered important in the development of a disease from viral infection, according to Hwa. But COVID-19 and the body’s resulting immune response can lead to damage in many different cells and cause a wide range of complications — including those related to platelets and endothelial cells.
“A major adverse outcome of those critically ill with Covid19 is formation of blood clots, many of which are likely undiagnosed,” Chun wrote in an email to the News. “This is likely occurring due to a combination of endothelial injury/activation and platelet activation.”
To make matters worse, the functions of these cells can already be compromised in elderly people and in people with diabetes or other cardiovascular risk factors. Then, when the cells are introduced to COVID-19, the “perfect storm” that Hwa described forms.
Another complication can come in the form of elevated cytokine levels, according to Jennifer Kwan, co-author of the review and clinical fellow at the Yale School of Medicine.
“The cytokines are essentially our messaging system released by immune cells to ramp up the immune defense or offense against a microbial threat,” Kwan said. “But when
Maradona Undergoes Successful Brain Surgery On Blood Clot
Argentine football great Diego Maradona underwent successful brain surgery for a blood clot in a specialist private clinic in Buenos Aires on Tuesday, his doctor said.
“We managed to successfully remove the clot. Diego coped well with the surgery,” Leopoldo Luque said at the icon’s private clinic in the capital Buenos Aires.
“It’s under control, there’s a little drainage (of blood). He’ll remain under observation.”
World Cup winner Maradona had been taken to hospital in La Plata — where he is the coach of top flight side Gimnasia y Esgrima — on Monday for a series of tests after feeling unwell.
A scan revealed the blood clot, and on Tuesday he was transfered to the specialist clinic in a northern neighborhood of the capital.
Maradona, who turned 60 on Friday, has suffered ill health before. He has survived two heart attacks, and also contracted hepatitis and undergone gastric bypass surgery.
Groups of fans congregated outside the clinic with banners showing Maradona’s face and the words “Come on, Diego!”
“I came with my wife to support the greatest player of all time,” fan Oscar Medina told AFP.
“Once more his health has played a trick on him but he has antibodies to recover with the help of the people,” added Medina.
“I feel very sad and impotent but we’re going to stay by his side until the last day,” said another fan, Matias Di Sciosio.
Earlier on Tuesday, Luque insisted it was “a routine operation” and that Maradona was “lucid” and “calm.”
Argentine media speculated the clot was the result of a blow to the head.
Luque said the clot was “imperceptible” and that those suffering from one rarely remembered receiving a knock to the head.
“The operation consists of a small incision to drain the blood. In 24 or 48 hours the patient can leave the hospital,” neurosurgeon Raul Matera told TyC Sports channel.
Maradona was transferred from the hospital in La Plata, 60 kilometers (37 miles) south of Buenos Aires, to the capital at 6:00 pm (2100 GMT) accompanied by one of his daughters, Giannina.
Dozens of Gimnasia fans outside the La Plata hospital chanted his name as he left.
Earlier in the day, Luque claimed Maradona was feeling “much better and eager to leave” hospital but insisted that the Gimnasia Y Esgrima coach was suffering from anemia — a lack of iron in his system — and dehydration.
Luque said it has
Viral load may predict ventilator need, death risk; coronavirus damages red blood cells
By Nancy Lapid
(Reuters) – The following is a roundup of some of the latest scientific studies on the novel coronavirus and efforts to find treatments and vaccines for COVID-19, the illness caused by the virus.
Viral load predicts need for ventilator, death risk
When COVID-19 patients are admitted to the hospital because of pneumonia, doctors can estimate their risk of needing mechanical breathing support or dying based on their “viral load” – the amount of virus genetic material obtained by swabbing the back of the nose and throat, a new study suggests.
“This risk can be predicted regardless of how sick they are when they are admitted, what other comorbidities they may have, their age or how many days they had symptoms,” coauthor Dr. Ioannis Zacharioudakis of NYU School of Medicine told Reuters. His team studied 314 patients, dividing them into three groups according to viral load upon hospital admission.
The group with highest viral levels had 59% higher odds of becoming critically ill or dying than the lowest viral load group. The data, published on Friday in Annals of the American Thoracic Society, “will have practical implications in our ability to judge which patients will benefit the most from early escalation of care, treatment with antivirals and/or inclusion in trials of new therapeutics,” Zacharioudakis said. (https://bit.ly/3oJijtQ)
Coronavirus damages red blood cell membranes
The new coronavirus damages the membranes of oxygen-carrying red blood cells, contributing to the hypoxemia, or low blood concentrations of oxygen, common in COVID-19, researchers have found. Signs of hypoxemia can range from shortness of breath to organ and tissue damage. Studying blood samples from COVID-19 patients and healthy individuals, researchers found the virus did not appear to affect red cells’ ability to pick up oxygen and deliver it throughout the body.
But patients had “clear damage” to red cell membranes, in particular to a membrane protein responsible for helping the cell survive injuries. As a result, patients’ red cells might be more vulnerable to so-called oxidative stress and other injury, coauthor Angelo D’Alessandro of the University of Colorado Denver said in an email.
Red cells circulate for up to 120 days before the body replaces them with new ones, and they cannot synthesize new components to replace the damaged parts. This might help explain why some COVID-19 symptoms can last for months, D’Alessandro said. (https://bit.ly/3mMBq4A)
Pandemic exacts toll on ER doctors’ mental health
COVID-19 is taking a toll on emergency physicians’ mental health and many are reluctant to seek help, according to poll results reported at the American College of Emergency Physicians (ACEP) annual meeting. Among a nationally representative group of 862 U.S. emergency physicians, 87% reported feeling more stressed since the pandemic began and 72% reported more burnout.
More than 80% cited concern for their own health and safety, and the safety of their family and friends, around contracting COVID-19. Nearly half said they are uncomfortable seeking mental health services, 73% said there was at least some stigma to seeking these services
Rise in nighttime blood pressure increases heart disease risk, study finds
Nov. 2 (UPI) — People who have high blood pressure at night are at increased risk for heart disease, even if their blood pressure is within normal ranges during the day, according to a study published Monday by the journal Circulation.
A nighttime systolic blood pressure — the “top” number — that is 20 millimeters of mercury — or mm. Hg, the unit of measure for blood pressure — above daytime readings raises a person’s risk for heart disease by 18%, the data showed.
That same rise in nighttime blood pressure also increases a person’s risk for heart failure by 25%, the researchers said.
“Nighttime blood pressure is increasingly being recognized as a predictor of cardiovascular risk,” study co-author Dr. Kazuomi Kario said in a statement.
“This study provides much more in-depth information about the cardiovascular risk associated with high nighttime blood pressure,” said Kario, a professor of cardiovascular medicine at Jichi Medical University in Japan.
Nearly half of all adults in the United States — or 108 million people — have high blood pressure, the Centers for Disease Control and Prevention estimates.
Research suggests that up to 40% of people experience rises in systolic blood pressure at night, whether or not their blood pressure is considered normal or healthy — between 90 mm. Hg and 120 mm. Hg — during the day.
For this study, researchers measured daytime and nighttime systolic blood pressure in 6,359 adults from across Japan between 2009 and 2017, using an at-home, wearable, ambulatory monitor.
Blood pressure was recorded during daily activities and sleep for at least 24-hours at a time, and device data were periodically downloaded at a healthcare clinic, the researchers said.
Nearly half of the study participants were male, and more than half were aged 65 years and older, according to the researchers.
All of the study participants had at least one risk factor for heart disease — although none had been diagnosed with it — and 75% of them were taking blood pressure medications when the study began, the researchers said.
The study participants were instructed to rest or sleep during nighttime hours and maintain their usual daytime activities, and they recorded their daily activities and sleep and wake times in a diary.
Nearly every participant recorded 20 daytime and seven nighttime automated blood pressure measurements.
By the end of the study period, participants experienced a total of 306 cardiovascular events, including 119 strokes, 99 diagnoses of coronary artery disease and 88 diagnoses of heart failure.
Those with a disrupted circadian blood pressure rhythm — or higher blood pressure at night than during the day — had a 48% higher risk for heart disease and were nearly three times as likely to experience heart failure, the data showed.
Circadian rhythms are the body’s natural, internal process that regulates a person’s sleep-wake cycle and repeats with each rotation of the Earth, or roughly every 24 hours, according to the American Heart Association.
Blood pressure typically fluctuates with a pattern that follows the
Beware of Blood Pressure Changes at Night | Health News
By Serena Gordon HealthDay Reporter
(HealthDay)
MONDAY, Nov. 2, 2020 (HealthDay News) — If your blood pressure changes a lot overnight — either rising or falling — you may have an increased risk of heart disease and stroke, a new study from Japan reports.
When systolic blood pressure (the top number) jumps up by 20 mm/Hg or more during the night, the risk of heart disease and stroke goes up by 18% and the risk of heart failure increases by 25%.
If people consistently had higher blood pressure readings at night, but normal readings during the day, the risk of heart failure more than doubled. The researchers, writing in the journal Circulation, dubbed this a “riser pattern.”
On the other hand, for people with a drop in blood pressure of more than 20%, the study team noted a more than twice the risk of stroke. They called this group “extreme dippers.”
“Nighttime blood pressure is increasingly being recognized as a predictor of cardiovascular risk,” study lead author Dr. Kazuomi Kario said in a journal news release. He’s chair of cardiovascular medicine at the Jichi Medical University in Tochigi, Japan.
Dr. Raymond Townsend, an expert volunteer for the American Heart Association, said blood pressure is typically higher in the morning and lower in the afternoon and evening.
Compared to the overall daytime blood pressure pattern, “blood pressure is generally about 10% to 20% lower during sleep. Sleep time offers a relatively pure look at blood pressure. Most factors that influence blood pressure are minimized during sleep,” he explained.
But health care professionals usually rely on in-office blood pressure measurements taken during the day to diagnose high blood pressure and to figure out whether or not a blood pressure medication is working or not, the researchers said. These daytime measurements may miss high blood pressure that happens at night. They can also miss big dips in blood pressure.
Dr. John Osborne, director of cardiology at State of the Heart Cardiology in Dallas, said, “When we measure blood pressure in the office, we’re mainly getting daytime blood pressure. Seeing what happens at night can give us a much deeper insight.”
Osborne said this study “is another signal that we really need to incorporate ambulatory blood pressure monitoring into the evaluation of high blood pressure. If we only see blood pressure during the day, it dramatically reduces our ability to assess overall risk.”
Ambulatory blood pressure monitoring allows doctors to see blood pressure levels over a 24-hour period, according to the American Academy of Family Physicians. Patients are fitted with a blood pressure cuff and sent home with a portable monitor that automatically inflates at regular intervals. The machine also records each blood pressure reading it takes in a day.
The current study included more than 6,300 Japanese adults. Their average age was 69. Almost half were men, and more than three-quarters were on blood pressure lowering medications. The average follow-up time was four years.
During the study, volunteers had 20 daytime and
Social Isolation Tied to High Blood Pressure in Women
Women who are socially isolated have an increased risk for high blood pressure, researchers report. But men, not so much.
Scientists used data on 28,238 Canadian men and women aged 45 to 85 who are participating in a large continuing study on aging.
The researchers found that compared with married women, single women had a 28 percent higher risk of hypertension, divorced women a 21 percent higher risk, and widowed women a 33 percent higher risk.
Social connections were also significant. Compared with the one-quarter of women with the largest social networks — which ranged from 220 to 573 people — those in the lowest one-quarter, with fewer than 85 connections, were 15 percent more likely to have high blood pressure.
The associations were different, and generally weaker, in men. Men who lived alone had a lower risk of hypertension than men with partners, but the size of men’s social networks, or their participation in social activity, was not significantly associated with high blood pressure.
The senior author, Annalijn I. Conklin, an assistant professor at the University of British Columbia, said that the most important finding is that social ties seem to be more meaningful for women than for men. “Social ties matter for cardiovascular health,” she said, “and they matter more for women.”
Veteran does 176,200 push-ups during blood cancer fight to honor others with disease
One veteran is truly showing what it means to be “Army Strong.”
© Courtesy of Nathan Tirey
Former Army Sgt. Nathan Tirey on the last day of his personal push-up challenge.
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When former Army Sgt. Nathan Tirey found out that he had blood cancer in 2019, he was determined to fight the illness alongside his fellow Americans battling the same disease.
Tirey decided to complete one push-up for each American diagnosed with blood cancer annually. This October, Tirey completed his 176,200th push-up.
© ABC News
Former Army Sgt. Nathan Tirey was diagnosed with blood cancer in 2019 and decided to complete 176,200 push-ups while going through treatment.
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Tirey documented the personal challenge on his YouTube channel, Pushing Through Cancer, which he used to raise awareness about his mission and those affected by blood cancer.
MORE: ‘Like a yo-yo’: Election officials grapple with flood of confusing last-minute rule changes
Gallery: Trump’s Doctors Should Worry About This, Says Dr. Fauci (ETNT Health)
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Even on the days he received treatment, Tirey would average around 484 push-ups a day.
“I’m in treatment right now, so I’m doing it while I’m getting treated,” Tirey shared on YouTube.
Tiery’s children, Nathan Tirey Jr. and Victoria Tirey, joined him on his last day of push-ups nearly a year after he was diagnosed.
After the final push, his wife, Megan Tirey, gave him a kiss. Nathan Tirey was overcome with gratitude for all of the support.
© Courtesy of Nathan Tirey
Former Army Sgt. Nathan Tirey on the last day of his personal push-up challenge.
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“Dealing with the treatment and everything this year… This helped me [with] mentallybeing able to withstand that,” Tirey said in a YouTube video.
MORE: 4-year-old twin girls dress as presidential candidates Donald Trump and Joe Biden
Tirey told “World News Tonight” on Wednesday that fighting through hard times is what brings Americans together.
“It’s always a grind to go through hard times and I want America to remember that we all have hard times. That’s something that bonds us together,” Tirey said. “We all go through hardships and hard times, but we can get through it if we just push through and put one foot in front of the other.”
Chinese medicine regulator to review EdiGene’s therapy for blood disorders
Pakistani patient suffering from thalassemia receives blood at a medical center on the World Thalassemia Day in Islamabad, Pakistan, on May 8, 2018. Thalassemia, also called Mediterranean anemia, is an inherited and non-infectious blood disorder. (Xinhua/Ahmad Kamal)
The China National Medical Products Administration (NMPA) will review biotech company EdiGene’s investigational new drug (IND) application for ET-01, an investigational gene-editing therapy for patients with transfusion-dependent beta-thalassemia (an inherited blood disorder), according to the company’s website.
The trial of ET-01 is expected to assess its safety and efficacy in transfusion-dependent beta-thalassemia patients. In China, it is estimated that there are 30 million thalassemia gene carriers, and over 300,000 patients with thalassemia major or thalassemia intermediate. Serious unmet medical needs remain for transfusion-dependent beta-thalassemia patients today.
“We are happy to achieve this important milestone and bring ET-01 closer to clinical-use stage,” said Dong Wei, CEO of EdiGene. “We are committed to translating cutting-edge gene-editing technologies into transformative therapies so as to bring patients better choices, and for some, a potential one-time cure. We look forward to receiving approval from NMPA and initiating ET-01 clinical studies in the near future,” he added.
ET-01 is an investigational gene-edited hematopoietic stem cell therapy for transfusion dependent beta-thalassemia patients.
EdiGene is a biotech company developing genome editing technologies to accelerate drug discovery and develop novel therapeutics for a wide range of illnesses.
Global Times
Global Blood Ketone Meter Market to Surpass US$ 486.3 Million by 2027, Says Coherent Market Insights (CMI)
According to Coherent Market Insights, the global blood ketone meter market is estimated to be valued at US$ 301.7 million in 2020 and is expected to exhibit a CAGR of 7.1% during the forecast period (2020-2027).
Key Trends and Analysis of the market:
The increasing number of product launches is expected to drive growth of the blood ketone meter market during the forecast period. For instance, in March 2020, EKF Diagnostics, the global in vitro diagnostics company, announced the launch of the U.S. FDA CLIA-waived β-ketone and glucose POC analyzer STAT-Site WB Analyzer in the U.S. market. This device is a new addition to its diabetes care portfolio in the U.S. The STAT-Site WB is a dual-use whole blood β-ketone and glucose meter for professional use in the management of diabetes.
Key manufacturers operating in the blood ketone meter market are engaged in developing more advanced products for the ease of diabetes patients. For instance, blood glucose & ketone testing meter by Foracare Inc., called FORA 6 Gtel, is a device that comes with 3G/4G connectivity. It can seamlessly transfer data to a TeleHealth System without the need for pairing it with a smartphone. With 5-Electrode Technology and strips made with gold, FORA 6 test strips ensure high accuracy and precision. It measures six parameters such as glucose, hematocrit, hemoglobin, β-ketone, total cholesterol, and uric acid in blood.
The global blood ketone meter market is expected to witness significant growth, owing to increasing partnerships and collaborations. For instance, in February 2020, the global diabetes nonprofit Beyond Type 1 announced a new collaboration with the National Association of School Nurses to create awareness about the warning signs of type 1 diabetes (T1D). With this new collaboration, awareness materials will be distributed to tens of thousands of school nurses nationally in the U.S. Moreover, Beyond Type 1 advocates will be enhancing efforts in ten target states: Arkansas, Connecticut, Florida, Massachusetts, New Jersey, North Carolina, Ohio, Oklahoma, Pennsylvania, and Texas.
Request Sample Copy of this Report @ https://www.coherentmarketinsights.com/insight/request-sample/3498
Key Market Takeaways:
The global blood ketone meter market is expected to exhibit a CAGR of 7.1% during the forecast period (2020-2027), owing to the rising prevalence of type 1 diabetes worldwide. For instance, according to the National Diabetes Statistics Report by Centers for Disease Control and Prevention of 2017, around 1.25 million Americans suffered from type 1 diabetes and over 300,000 Canadians lived with type 1 diabetes in 2017. Furthermore, as per the same source, over 100,000 children in India and 50,000 children and adolescents in China were living with type 1 diabetes as of 2017.
Key players in the North America blood ketone meter market are focused on launching new products, which is expected to drive growth of the market during the forecast period. For instance, in March 2020, EKF Diagnostics launched the STAT-Site WB, a blood β-ketone and glucose meter in the U.S. The device is used for measuring ketone and for the management of diabetes.
Competitive Landscape:
Key players
FDA approves remdesivir; Halloween; blood supply shortage
Former President Barack Obama took aim at President Donald Trump’s COVID-19 response at a rally in Philadelphia for Joe Biden.
Associated Press
Moderna announced a crucial step Thursday in its progress toward winning approval for a COVID-19 vaccine, saying it has secured all 30,000 participants for its Phase 3 study, more than a third of whom are of color. Meanwhile, the FDA approved the antiviral medicine remdesivir as a treatment for COVID-19.
“Completing enrollment of the Phase 3 COVE study is an important milestone for the clinical development of our vaccine,” CEO Stéphane Bancel said. “We are indebted to all of the participants.”
A vaccine can’t come fast enough. Blood supply agencies warn that demand is outstripping supply, and that things could get worse when flu season kicks into high gear later in the fall.
“A month or two ago we were at probably a good place … because so many heard that message to come out (and donate),” said Kate Fry, CEO of America’s Blood Centers. “But now it’s lost that momentum. We see the blood supply steadily decrease.”
In Massachusetts, Salem is known as “Witch City” and draws big Halloween crowds. Not this year. Officials have announced stricter guidelines for Halloween to prevent gatherings. Businesses will shut down early, city officials will triple fines over the Halloween weekend, and streets will be closed.
Some significant developments:
- Spain is the first country in western Europe to reach 1 million cases of COVID-19.
- Boston public schools are switching to all-remote learning starting Thursday in response to a rise in coronavirus cases.
- Former President Barack Obama, in his first campaign event for Joe Biden, slams President Trump’s response to the pandemic.
📈 Today’s numbers: The U.S. has reported more than 8.3 million cases and 222,000 deaths, according to Johns Hopkins University data. The global totals: 41 million cases and 1.1 million deaths.
🗺️ Mapping coronavirus: Track the U.S. outbreak in your state.
Worked to death: Latino farmworkers have long been denied basic rights. COVID-19 showed how deadly racism could be. Read the latest installment in USA TODAY’s series, Deadly Discrimination.
When will there be a COVID vaccine? In general, scientists and public health experts say a COVID-19 vaccine could be approved at the earliest by December, but that doesn’t mean it will be widely available to most Americans. The federal government is developing a distribution plan that would get vaccine to various populations first, such as essential workers, those most vulnerable to COVID-19 and the elderly. See what USA TODAY’s expert panel has to say.
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FDA approves remdesivir as treatment for COVID-19 patients
The Food and Drug Administration (FDA) on Thursday approved the antiviral drug remdesivir as a treatment for patients with COVID-19 who require hospitalization.
As an antiviral drug, remdesivir works to stop replication of SARS-CoV-2, the virus that causes