A new cohort study has found that people who have had COVID-19 are at an increased risk of developing Type 2 diabetes.
As described in a paper published Wednesday in the peer-reviewed medical journal Diabetologia, researchers at the German Centre for Diabetes Research and the German Diabetes Centre looked at the data of 8.8 million patients from 1,171 primary care physicians in Germany between March 2020 and January 2021. Follow-up continued until July 2021, according to the study.
“The aim of our study was to investigate the incidence of diabetes after infection with SARS-CoV-2,” said first author and epidemiologist Wolfgang Rathmann in a press release.
During the study period, 35,865 individuals among the cohort were diagnosed with COVID-19. These individuals mostly had mild symptoms, and were treated in primary care settings rather than being hospitalized.
Another 35,865 individuals were selected to be a part of a control group made up of people with non-COVID-19-related acute upper respiratory tract infections (AURI), affecting the sinuses and throat. Patients in the COVID-19 group were compared against individuals in the AURI group based on their age, sex, time of diagnoses and comorbidities.
The researchers found that patients with COVID-19 developed Type 2 diabetes more frequently compared to those in the AURI group. For those with COVID-19, the incidence rate of Type 2 diabetes was 15.8 out of 1,000 people per year. In the AURI group, the incidence of diabetes was only 12.3 per 1,000 people per year.
“Put simply, this means that the relative risk of developing Type 2 diabetes was 28 per cent higher in the COVID-19 group than in the AURI group,” Rathmann said in the release.
Researchers say the human pancreas is a target of SARS-CoV-2, the virus that causes COVID-19. Because of this, an infection could damage beta cells in the pancreas and impair the secretion of insulin. Cases of new-onset hyperglycaemia and insulin resistance have been reported in COVID-19 patients with no prior history of diabetes, according to who?
However, the researchers say it’s still not clear whether diabetes becomes apparent during COVID-19 infection due to immune activation or stress. It’s also unclear whether post-COVID-19 diabetes may be reversed after a full recovery from infection.
The researchers suggest anyone who has or had COVID-19 should be on the lookout for warning signs and possible symptoms of diabetes, such as fatigue, frequent urination and increased thirst.
This is not the first study to investigate at a possible link between diabetes and COVID-19. A U.S. Centers for Disease Control and Prevention report published in January found that diabetes was substantially more common in kids who had COVID-19. However, the report didn’t distinguish between Type 1, which typically starts in childhood, and Type 2, the kind tied to obesity.
With files from The Associated Press.
Deadly fungal infections a concern in patients post-COVID-19, flu | CTV News – CTV News Calgary
While fungi are not about to start turning the human race into zombies, like in the HBO blockbuster series The Last of Us, the World Health Organization (WHO) says invasive fungal infections are an increasing threat to human health.
Aspergillosis is one fungal infection common in our environment but, in some circumstances, it can turn deadly. In an average day, most of us will inhale hundreds to thousands of Aspergillus spores with no adverse effects, but for people with weakened immune systems it can cause deadly infections. That includes people undergoing cancer treatments, or bone marrow transplants, but it is now recognized that some viral infections, like influenza (flu) and SARS-CoV-2 (COVID-19) increase the risk of deadly fungal infection even in otherwise healthy people.
“When these kinds of things happen in the ICU, it can be devastating because even advanced medicines still can’t treat these infections,” said Dr. Bryan Yipp, an intensive care physician and researcher at the University of Calgary.
“Once many of these infections really get ingrained and take over, clearing them with medications alone, antifungal or anti microbials, can be very difficult.”
Dr.Yipp began studying Aspergillus — a type of fungus that is a common mould — and its connection to viral infections in 2019, following three deaths in intensive care units of patients initially admitted for influenza, but who subsequently died of the fungal infection.
“It was very much a surprise when people first started identifying the fungus in the lung. There was a lot of discussion around the table of ICU doctors, infectious disease doctors, asking ‘Was Aspergillosis really the cause of death, or was this just a secondary finding?'” said Yipp. “The pathologists who looked at the samples and the autopsies, were convinced that it was Aspergillosis that was the main problem.”
UCalgary researchers have determined exposure to Aspergillus, a common fungal mould, can lead to a potentially dangerous Aspergillosis infection in people with weakened immune systems.
Working in Yipp’s lab, lead researcher Nicole Sarden, a PhD candidate, isolated the mechanism by which the immune system starts failing to prevent fungal infections.
“In healthy humans. specific immune cells, called B cells, produce molecules (antibodies) that basically tag invaders so that other cells in the immune system, called neutrophils, can recognize them, eat them, and clear the infection,” said Sarden
“But when you have infections with viruses, such as influenza, or if you get COVID, these molecules are no longer present, which means that the immune systems that are trying to eat, and clear the fungi cannot do it because they cannot see it.”
Working with both mice and human blood and tissue samples, the researchers discovered that following a viral infection, neutrophils could identify a fungal infection and surround it but did nothing to destroy it.
“The virus kills the B cells, no messenger molecules exist, so the neutrophils that would normally attack, the fungus, are blinded. They sit there and don’t know what to do,” said Sarden.
The research team also discovered that reintroducing Aspergillosis reactive antibodies can protect infected mice, leading to hopes a similar treatment will be available in the near future for humans with Aspergillosis infections.
While Yipp and Sarden focused on Aspergillus, it is not the only fungus that can cause serious, or fatal infections. It is estimated fungal infections kill an estimated 1.5 million people worldwide every year. Most of those are due to four different fungi; Cryptococcus, Candida, Aspergillus, and Pneumocystis. Since the advent of COVID, a previously rare infection of the fungus Mucormycosis has been increasing rapidly in India. It affects the sinuses, brains and lungs of its victims. The rise in Mucormycosis has also been seen in patients who are recovering or have recently recovered from COVID.
Yipp is hopeful the research being conducted at Calgary’s Cumming School of Medicine could lead to treatments for these infections as well.
“We have some hunches that that could be a similar mechanism to what we see here with what we have found.” said Yipp. “So we think that this could be applied to multiple different types of fungi around the world.”
The research team, led by Sarden, published their findings in the journal Science Translational Medicine.
Barrie hospital declares COVID outbreak in transitional care unit – BarrieToday
Royal Victoria Regional Health Centre (RVH), in collaboration with the Simcoe Muskoka District Health Unit, declared a COVID-19 outbreak in the Barrie hospital’s transitional care unit on Friday, Jan. 27.
According to RVH, eight patients have tested positive for COVID-19 and have been isolated.
“Enhanced cleaning measures are underway, as well as swabbing of patients and staff,” RVH said in a news release Monday afternoon.
Admissions to the unit are on hold at this time, and visitors are not permitted. However, RVH says some exceptions may apply.
Guidance for diagnosing and managing migraine – News-Medical.Net
Migraine is a major cause of disability, affecting about 12% of people. A 2-part series published in CMAJ (Canadian Medical Association Journal) on diagnosing and managing the condition with both acute and preventive therapy provides guidance for clinicians. https://www.cmaj.ca/lookup/doi/10.1503/cmaj.211969.
“The goal of treatment of migraine attacks is to provide rapid relief from pain and other migraine-related symptoms, to restore patient function and to prevent recurrence,” writes Dr. Tommy Chan, Department of Clinical Neurological Sciences, Western University, London, Ontario, with coauthors.
“A stratified approach to treatment that empowers patients to choose from different options, depending on attack symptoms and severity, and encourages them to combine medications from different classes (e.g., nonsteroidal anti-inflammatory drugs and triptans) for severe or prolonged attacks, is preferred.”
Part 2 of the review, which will be published February 6, focuses on preventive treatment to reduce the frequency and severity of migraine attacks.
Tzankova, V., et al. (2023) Diagnosis and acute management of migraine. Canadian Medical Association Journal. doi.org/10.1503/cmaj.211969.
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