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COVID-19 and aspirin: Can this common drug in your medicine cabinet reduce your risk of dying from COVID? Here’s what a new study found

At least 29 million Americans take low-dose aspirin every day in hopes of preventing a heart attack or stroke.

Now, a new University of Maryland study found that hospitalized COVID-19 patients, who were taking a daily 81-milligram dose of aspirin, had a significantly lower risk of complications than those not taking aspirin.

“Forty percent across the board did not require a ventilator, did not need to go to the ICU,” explained Dr. Michael Daignault, an ER physician at Providence St. Joseph Hospital.

MORE: Moderna’s COVID-19 vaccine could be up to 94.5% effective

Dr. Daignault says aspirin’s ability to reduce blood clots may be the key.

“We know that aside from being a respiratory virus, that COVID-19 at the local organ level causes a lot of mini clots,” Dr. Daignault said.

Clotting and inflammation is what sends many patients into the ICU.

So during this pandemic, should everyone be taking daily baby aspirin? Dr. Daignault says this was a small correlation study and without more research, he would not advise it.

“It’s hard to say if they got better because of the aspirin specifically or because of other reasons,” Dr. Daignault explained.

MORE: People with blood type O may have lower risk of COVID-19, studies suggest

A Harvard study found more than six million Americans are taking aspirin without a doctor’s advice or knowledge. Experts say for people who don’t have severe cardiovascular issues, the risks may outweigh the potential benefits.

“Aspirin can raise your risk of having gastritis or irritation of your stomach lining or a ulcer or an upper gastrointestinal bleed,” Dr. Daignault said.

If you’re thinking about taking a daily baby aspirin for any health reason, it’s important that you discuss this with your doctor first.

“Aspirin is cheap, it’s widely available, and it could be a potential game changer, but we definitely need more perspective or robust studies,” Dr. Daignault said.

RELATED | Which masks protect those around you best? Researchers weigh in

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New medicine reduced risk for heart failure emergencies, hospital visits

Embargoed until 10:35 a.m. CT/11:35 a.m. ET, Friday, Nov. 13, 2020

DALLAS, Nov. 13, 2020 — Omecamtiv mecarbil, a new, investigational heart medication, reduced the risk of heart failure-related events in patients with heart failure with reduced ejection fraction, according to late-breaking research presented today at the American Heart Association’s Scientific Sessions 2020. The virtual meeting is Friday, November 13 – Tuesday, November 17, 2020, and is a premier global exchange of the latest scientific advancements, research and evidence-based clinical practice updates in cardiovascular science for health care worldwide. The manuscript of this study is simultaneously published today in The New England Journal of Medicine.

Ejection fraction is a measurement of the proportion of blood the heart pumps out with each contraction. Heart failure with reduced ejection fraction, or HFrEF, occurs when the left ventricle, the heart’s largest pumping chamber, loses its ability to contract normally. The heart can’t pump with enough force to push blood into circulation. An ejection fraction of 40% or less is used to define HFrEF. For this study, an EF of ? 35% was required.

The GALACTIC-HF (Global Approach to Lowering Adverse Cardiac Outcomes Through Improving Contractility in Heart Failure) study assessed omecamtiv mecarbil, an investigational medication that was granted “fast track” designation as a new heart failure treatment option by the U.S. Food and Drug Administration in May 2020.

Omecamtiv mecarbil binds to cardiac myosin, the protein in the heart that transforms chemical energy into mechanical work, thus powering muscle contraction. In previous studies, it was found to improve cardiac function by increasing the effectiveness by which myosin interacts with actin, another protein involved in heart muscle contraction.

“Omecamtiv mecarbil is the first in a class of heart medicines called myotropes that selectively target cardiac muscle to improve cardiac performance,” said John R. Teerlink, M.D., lead author of the study, director of heart failure and of the Echocardiography Laboratory at the San Francisco Veterans Affairs Medical Center and professor of medicine at the University of California San Francisco. “In the phase 2 study that led to GALACTIC-HF, omecamtiv mecarbil increased measures of cardiac performance and function. GALACTIC-HF focused on evaluating the effect of this potential medication on outcomes in patients with chronic heart failure.”

GALACTIC-HF was a phase 3, multicenter, randomized, double-blind, placebo-controlled trial. The study enrolled more than 8,000 patients in 35 countries with chronic heart failure who were either currently hospitalized for heart failure or with a recent history of hospitalization or emergency department visit for heart failure within one year prior to screening.

Participants were predominantly male (79%) and white* (78%), with an average age of 66 years and average ejection fraction of 27%. In addition:

62% had coronary artery disease;

  • 40% had Type 2 diabetes;
  • 70% had high blood pressure;
  • 36% had chronic kidney disease; and
  • 25% were hospitalized at the time of enrollment.

* While only 7% of participants self-reported as Black, more Black patients were enrolled in GALACTIC-HF than in any contemporary, international heart failure trial.

Patients

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Low fitness linked to higher depression and anxiety risk

People with low aerobic and muscular fitness are nearly twice as likely to experience depression, finds a new study led by UCL researchers.

Low fitness levels also predicted a 60% greater chance of anxiety, over a seven-year follow-up, according to the findings published in BMC Medicine.

Lead author, PhD student Aaron Kandola (UCL Psychiatry) said: “Here we have provided further evidence of a relationship between physical and mental health, and that structured exercise aimed at improving different types of fitness is not only good for your physical health, but may also have mental health benefits.”

The study involved 152,978 participants aged 40 to 69 of the UK Biobank study. Their baseline aerobic fitness at the start of the study period was tested by using a stationary bike with increasing resistance, while their muscular fitness was measured with a grip strength test. They also completed a questionnaire gauging depression and anxiety symptoms.

Seven years later they were tested again for depression and anxiety symptoms, and the researchers found that high aerobic and muscular fitness at the start of the study was associated with better mental health seven years later.

People with the lowest combined aerobic and muscular fitness had 98% higher odds of depression, 60% higher odds of anxiety, and 81% higher odds of having either one of the common mental health disorders, compared to those with high levels of overall fitness.

The researchers accounted for potentially confounding factors at baseline such as diet, socioeconomic status, chronic illness, and mental illness symptoms.

Previous studies have found that people who exercise more are less likely to experience mental illnesses, but most studies rely on people self-reporting their activity levels, which can be less reliable than the objective physical fitness measures used here.

Senior author Dr Joseph Hayes (UCL Psychiatry and Camden and Islington NHS Foundation Trust) said: “Our findings suggest that encouraging people to exercise more could have extensive public health benefits, improving not only our physical health but our mental health too. Improving fitness through a combination of cardio exercise and strength and resistance training appears to be more beneficial than just focusing on aerobic or muscular fitness.”

Aaron Kandola added: “Reports that people are not as active as they used to be are worrying, and even more so now that global lockdowns have closed gyms and limited how much time people are spending out of the house. Physical activity is an important part of our lives and can play a key role in preventing mental health disorders.

“Other studies have found that just a few weeks of regular intensive exercise can make substantial improvements to aerobic and muscular fitness, so we are hopeful that it may not take much time to make a big difference to your risk of mental illness.”

###

The research involved academics at UCL, King’s College London and Harvard University, and was supported by Wellcome, the Medical Research Council, the UK Department of Health, the Scottish government, Northwest Regional Development Agency, Welsh Assembly government, the

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Higher fitness levels linked to lower AFib risk in male, African American veterans

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Credit: Unsplash/CC0 Public Domain

Higher fitness levels reduced the risk of developing an irregular heart rhythm, known as atrial fibrillation, by 30% to 50% in a study of male, African American veterans, according to preliminary research to be presented at the American Heart Association’s Scientific Sessions 2020.

Atrial fibrillation (also called AFib or AF) is an irregular heartbeat (arrhythmia) that can lead to blood clots, stroke, heart failure and other heart-related complications. According to the American Heart Association, at least 2.7 million Americans are living with AFib.

“Engaging in physical activity to increase fitness is an inexpensive and practical intervention that health care professionals can prescribe to patients to prevent and manage cardiovascular disease,” said lead researcher Apostolos Tsimploulis, M.D., a cardiology fellow at the State University of New York at Stony Brook. “All of our evidence suggests the health benefits associated with increased cardiorespiratory fitness and reduced risk of atrial fibrillation are the same for all adults regardless of race.”

To study the effects of exercise on the development of atrial fibrillation, researchers examined the medical records of more than 11,000 middle-aged, male African American veterans (average age 58) from 1985 to 2013. None exhibited evidence of heart disease during or prior to completing a symptom-limited treadmill stress test at two VA Medical Centers—in Washington, D.C., and Palo Alto, California.

Participants were categorized into four fitness groups based on their age-specific cardiorespiratory fitness (CRF). CRF was measured in metabolic equivalents, or METs, resting metabolic rate (1 MET=3.5 ml of O2/kg of body weight per minute). The groups were categorized as: least fit, moderately fit, fit and highly fit.

A search of medical records was conducted by two independent investigators to directly assess the association between CRF and atrial fibrillation. Models were adjusted for risk factors, including heart or blood pressure medications, age and body mass index.

During an average follow-up of 10.7 years, 1,423 veterans developed atrial fibrillation:

  • 421 (16.6%) in the least fit group;
  • 366(10.9%) in the moderately fit group;
  • 323 (11.9%) in the fit group; and
  • 313 (12%) in the high-fit group.

When compared to the least-fit group, the atrial fibrillation risk was:

  • 29% lower in the moderately fit group;
  • 37% lower in the fit group; and
  • 51% lower in the high fit group.

Researchers noted the study results are strong based on the number of participants, and atrial fibrillation incidence was established during a follow-up period spanning roughly 17 years (median 10.7 years). Access to adjusted, longitudinal data, including medications and heart risk factors, along with equal access to care (care from the VA regardless of a patient’s ability to pay) are significant factors. This permitted continuous follow-up and minimized the potential for disparities in medical care.

Tsimploulis noted the precise cause of atrial fibrillation was not determined. In addition, CRF was measured only once; the level or frequency of physical activity was not assessed; and follow-up data on changes in cardiorespiratory fitness or physical activity of the participants over time were not available.

“We cannot

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Penn Medicine researchers find link between food insecurity and cardiovascular death risk

PHILADELPHIA–Food insecurity is one of the nation’s leading health and nutrition issues–about 13.7 million (10.5 percent) of households in the United States were food insecure at some time during 2019, a trend likely to increase in light of the COVID-19 pandemic. According to preliminary research conducted by researchers at Penn Medicine, increasing rates of food insecurity in counties across the United States are independently associated with an increase in cardiovascular death rates among adults between the ages of 20 and 64.

The large-scale, national study, which will be presented at the American Heart Association’s Scientific Sessions 2020, provides evidence of the link between food insecurity and increased risk of cardiovascular death. This is one of the first national analyses to evaluate changes in both food security and cardiovascular mortality over time, and to see if changes in food insecurity impact cardiovascular health. The findings were also published today in Circulation: Cardiovascular Quality and Outcomes.

“This research gives us a better understanding of the connection between economic distress and cardiovascular disease,” said Sameed Khatana, MD, MPH, senior author of the study and instructor of Cardiovascular Medicine in the Perelman School of Medicine at the University of Pennsylvania. “What’s going on outside the clinic has significant impact on patients’ health. There are many factors beyond the medications we may be prescribing that can influence their wellbeing, food insecurity being one of them.”

Researchers analyzed data from the National Center for Health Statistics and the Map the Meal Gap study, to examine county-level cardiovascular death rates and food insecurity rates from 2011 to 2017, among adults age 20 to 64, and those 65 years and older.

The researchers found that while the overall food insecurity rates for the entire country declined between 2011 and 2017, the counties that had the most increase in food insecurity levels had cardiovascular death rates that increased from 82 to 87 per 100,000 individuals. Additionally, for every 1 percent increase in food insecurity, there was a similar increase in cardiovascular mortality among non-elderly adults (0.83 percent).

“There has been a growing disparity when it comes to food insecurity, and this data demonstrates that parts of the country are being left behind. Unfortunately, this may only get worse as the country grapples with the ramifications of the COVID-19 pandemic,” Khatana said. “However, interventions that improve a community’s economic wellbeing could potentially lead to improved community cardiovascular health.”

The authors intend to study whether interventions that improve food insecurity can lead to better cardiovascular health.

###

The abstract will be presented in Session QU.AOS.765 Social Determinants of Cardiovascular Health on November 13, 2020, at 9:00 am CST/10:00 am EST.

Penn co-authors include, Atheendar S. Venkataramani, Christina A. Roberto, Lauren A. Eberly, and Peter W. Groeneveld, along with Yale’s Stephen Y. Wang.

Penn Medicine is one of the world’s leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at

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There’s no extra Covid risk from living with kids, study finds

  • Living with children does not carry with it a greater risk of contracting Covid-19, according to a study in the U.K.
  • Living with children appears to lower the risk of dying from Covid-19.
  • The study looked at 9 million adults in the U.K. under the age of 65.



a group of people standing on top of a grass covered field: Students play during their break on their first day of school after the summer break at St Luke's Church of England Primary School in East London on September 3, 2020.


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Students play during their break on their first day of school after the summer break at St Luke’s Church of England Primary School in East London on September 3, 2020.

If you live with children, you’re not at a greater risk of contracting Covid-19, according to a large study carried out in the U.K.

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In fact, living with children was associated with a lower risk of dying from the coronavirus compared to those that didn’t live with children, researchers from the University of Oxford and London’s School of Hygiene and Tropical Medicine found.

They investigated 9 million adults in the U.K. under the age of 65 between February and August to see whether the risk of infection with Covid-19, and the risk of severe outcomes from having the virus, was different for those living with and without children.

The researchers found that living with children under the age of 11 “was not associated with increased risks of recorded Covid-19 infection, Covid-19 related hospital or ICU (intensive care unit) admission but was associated with reduced risk of Covid-19 death.”

However, living with children aged 12-18 years was associated with a small increased risk of recorded coronavirus infection, the study noted, but not associated with other Covid-19 outcomes.

Living with children of any age was associated with a lower risk of dying from non-Covid-19 causes, the researchers found.

The study also looked at an additional 2.5 million adults above the age of 65 and also found that “there was no association between living with children and outcomes related to Covid-19.”

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Researchers highlighted that parents are known to have lower all-cause mortality than individuals without children, noting that the “protective mechanisms of having children are likely to be multifactorial, including healthier behaviours among parents, e.g. in relation to smoking and alcohol, and self-selection of healthier individuals becoming parents.”

They also said “beneficial changes in immune function from exposure to young children have been proposed to cause reduced mortality among parents.”

Wrangling over schools

The study comes amid ongoing uncertainty over the role of children and adolescents in the transmission of the coronavirus. But the researchers in this study noted that there was “accruing evidence” that suggests that, when it comes to Covid-19, “lower susceptibility and possibly lower infectiousness among children means that they may not transmit infection more than adults.”

There has been heated debate over whether schools and colleges should remain open during national lockdowns, with millions of kids having to stay at home when governments first locked down their economies

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Proinflammatory Dietary Pattern Linked to Higher CV Risk

Dietary patterns with higher inflammatory potential were significantly associated with a higher incidence of cardiovascular disease (CVD) and stroke in a new pooled analysis of three prospective cohort studies.

The analysis included 210,145 US women and men followed for up to 32 years in the Nurses’ Health Studies I and II and the Health Professionals Follow-up Study.

After adjustment for use of anti-inflammatory medications and CVD risk factors, those whose dietary pattern ranked in the highest quintile of inflammatory potential had a 38% higher risk of CVD (hazard ratio comparing highest to lowest quintiles, 1.38), a 46% higher risk of coronary heart disease (HR, 1.46), and a 28% higher risk of stroke (HR, 1.28), all P for trend < .001.

Jun Li, MD, PhD, and colleagues at Harvard T.H. Chan School of Public Health and Harvard Medical School Boston, Massachusetts, published the findings of their study in the November 10 issue of the Journal of the American College of Cardiology.

The inflammatory potential of a diet was assessed using a food-based, dietary index called the “empirical dietary inflammatory pattern” or EDIP.

In an interview, Li explained that the EDIP was developed 4 years ago by many of the same authors involved with this study, including nutrition heavyweights Walter C. Willett, MD, DrPH, and Frank B. Hu, MD, PhD, both from Harvard.

“We summarized all the foods people eat into 39 defined food groups and did a reduced-rank regression analysis that looked at these 39 food groups and three inflammatory markers — interleukin-6 (IL-6), C-reactive protein (CRP), and tumor necrosis factor alpha receptor 2. We found 18 food groups that are most predictive of these biomarkers, and the EDIP was calculated as the weighted sum of these 18 food groups.”

Individuals who had higher intakes of green leafy vegetables (kale, spinach, arugula), dark yellow vegetables (pumpkin, yellow peppers, carrots), whole grains, fruits, tea, coffee and wine had lower long-term CVD risk than those with higher intakes of red meat, processed meat, organ meat, refined carbohydrates, and sweetened beverages. 

The associations were consistent across cohorts and between sexes and remained significant in multiple sensitivity analysis that adjusted for alcohol consumption, smoking pack-years, use of lipid-lowering and antihypertensive medications, sodium intake, and blood pressure.

In a secondary analysis, diets with higher inflammatory potential were also associated with significantly higher biomarker levels indicative of more systemic, vascular, and metabolic inflammation, as well as less favorable lipid profiles.

“We wanted to be able to provide guidance on dietary patterns and food combinations,” said Li. “If you tell people to eat more polyunsaturated fats instead of saturated fat or trans fat, most people don’t know what foods are higher and lower in those nutrients. Also, many foods have different nutrients — some of which are good and some of which are bad — so we wanted to help people find the foods with the higher proportion of healthy nutrients rather than point out specific nutrients to avoid.”

Researchers used prospectively gathered data from the Nurses’

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Pregnant women with coronavirus at higher risk of severe illness, death, CDC finds

Pregnant women who contract the coronavirus are more at risk for severe illness and death than non-pregnant women, a Centers for Disease Control and Prevention (CDC) analysis found. The agency has previously warned that pregnant people might be at an increased risk for severe illness from COVID-19, but research is ongoing.

The new report, issued Monday, analyzed data collected from over 400,000 women ages 15-44 with symptomatic COVID-19.

Of the 409,462 women with symptomatic coronavirus, 23,434 were pregnant.

CORONAVIRUS FACE MASKS AT POLLS ENCOURAGED, BUT NOT REQUIRED IN SOME STATES

“After adjusting for age, race/ethnicity, and underlying medical conditions, pregnant women were significantly more likely than were non-pregnant women to be admitted to an intensive care unit, receive ventilation, receive extracorporeal membrane oxygenation and die,” the report said.

The CDC said the findings may be due to the physiologic changes associated with pregnancy.

The CDC said the findings may be due to the physiologic changes associated with pregnancy.
(iStock)

The CDC said the findings may be due to the physiologic changes associated with pregnancy, including increased heart rate and oxygen consumption, decreased lung capacity, immunity changes and increased risk for thromboembolic disease.

POSTPARTUM DEPRESSION MAY LAST 3 YEARS AFTER CHILDBIRTH, STUDY FINDS

Separately, the analysis also found racial and ethnic disparities in both risks for infection and disease severity among pregnant women, “indicating a need to address potential drivers of risk in these populations,” the report said.

The health agency said pregnant women should be counseled about the importance of seeking prompt medical care if they develop symptoms of coronavirus, and that there should be a strong emphasis on coronavirus prevention for pregnant women at each medical appointment.

OVER HALF OF CORONAVIRUS-INFECTED PREGNANT WOMEN SHOWED NO SYMPTOMS, CDC FINDS

“To minimize the risk for acquiring SARS-CoV-2 infection, pregnant women should limit unnecessary interactions with persons who might have been exposed to or are infected with SARS-CoV-2, including those within their household, as much as possible,” the CDC said. “When going out or interacting with others, pregnant women should wear a mask, social distance, avoid persons who are not wearing a mask, and frequently wash their hands.”

CLICK HERE FOR COMPLETE CORONAVIRUS COVERAGE 

The CDC also advised pregnant women stay up to date with flu shots and prenatal care.

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Some types of ‘hard work’ actually increase dementia risk, study says

Physical activity is known to help prevent dementia and disease, but it’s possible that the kind you do makes a difference.

A new study found that hard physical work not only doesn’t lower the risk of dementia, it increases the risk of developing the disease.

Researchers found that people who do hard physical work have a 55 percent higher risk of developing dementia than those doing sedentary work.

“The WHO [World Health Organization] guide to preventing dementia and disease on the whole mentions physical activity as an important factor. But our study suggests that it must be a ‘good’ form of physical activity, which hard physical work is not,” said researcher Kirsten Nabe-Nielsen.

“Guides from the health authorities should therefore differentiate between physical activity in your spare time and physical activity at work, as there is reason to believe that the two forms of physical activity have opposite effects,” said Nabe-Nielson, an associate professor from the Department of Public Health at the University of Copenhagen.

Another study from the University of Copenhagen recently showed that a healthy lifestyle can halve the risk of developing dementia.

Researchers from the University of Copenhagen and the National Research Centre for the Working Environment used data from the Copenhagen Male Study, in which 4,721 Danish men reported in the 1970s about the type of work they did for 14 Copenhagen-based companies.

Over the years, researchers compiled health data on the respondents.

Now, researchers are collecting more data with the intent to identify healthier ways of doing hard physical work in a way that it has an “exercise effect.”

“A lot of workplaces have already taken steps to improve the health of their staff. The problem is that it is the most well-educated and resourceful part of the population that uses these initiatives,” said study co-author Andreas Holtermann.

“Those with a shorter education often struggle with overweight, pain and poor physical fitness, even though they take more steps during the day and to a larger extent use their body as a tool,” said Holtermann, of the National Research Centre for the Working Environment.

“For workmen, it is not enough, for example, to avoid heavy lifts if they wish to remain in the profession until age 70. People with a shorter education doing manual labour also need to take preventive steps by strengthening the body’s capacity via, for example, exercise and strength training,” Holtermann said in a university news release.

The research was published recently in the Scandinavian Journal of Medicine and Science in Sports.



More information

Visit the Mayo Clinic for more on physical activity.

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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

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