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Neurological problems no higher after vaccination; depression, anxiety risk tied to COVID severity

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The following is a summary of some recent studies on COVID-19. They include research that warrants further study to corroborate the findings and that has yet to be certified by peer review.

Neurological risks not higher after COVID-19 vaccines

COVID-19 vaccination did not increase risks for rare neurological conditions among more than 8 million people who had received at least one dose of a vaccine from AstraZeneca, Pfizer/BioNTech, Moderna or Johnson & Johnson, according to researchers.

Their study also included 735,870 unvaccinated individuals who had tested positive for the coronavirus, as well as older data on an additional 14.3 million people from the general population for a baseline estimate of rates of the neurological conditions before the pandemic. Researchers looked for four neurological disorders involving the immune system. Three of them – Bell’s palsy (facial weakness), encephalomyelitis (inflammation of the brain and spinal cord), and Guillain-Barré syndrome (a nerve condition) – were no more common in the vaccine recipients than in the general population, the researchers reported on Wednesday in The BMJ https://www.bmj.com/content/376/bmj-2021-068373. The fourth – transverse myelitis (inflammation of the spinal cord) – occurred too rarely for analysis (fewer than 5 cases in 8.3 million vaccinated people). The researchers did see increased rates of Bell’s palsy, encephalomyelitis and Guillain-Barré syndrome in COVID-19 survivors, however.

More research is needed to look for longer term adverse events of vaccination and SARS-CoV-2 infection and to study the effects of vaccines on different age groups, the researchers said. But it appears that COVID-19 vaccines are “a highly unlikely reason” for most neurological problems, they concluded.

Risk of depression, anxiety tied to COVID-19 severity

People who have been bedridden for seven days or more with COVID-19 are at increased risk of anxiety and depression, an international study found.

Researchers analyzed data from Denmark, Estonia, Iceland, Norway, Sweden and the UK collected between March 2020 and August 2021 on more than 247,000 people, including 9,979 who were diagnosed with COVID-19. Those who had COVID and were bedridden for at least a week had a 61% higher risk for symptoms of depression and a 43% higher risk for anxiety, for up to 16 months after their diagnosis compared to those who were never infected.

By contrast, patients who had COVID-19 but were never bedridden actually had significantly lower rates of depression than people who had never contracted the virus, researchers found. “This group may experience a relief after recovery from the relatively benign infection and are able to return to somewhat normal lives as compared to those not yet diagnosed with COVID-19, perhaps still fearing infection and therefore still limiting social contact,” said Dr. Anna Valdimarsdottir of the University of Iceland, whose team reported the findings in The Lancet Public Health https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(22)00042-1/fulltext. The results should alert clinicians to the possibility of long-term mental health symptoms in their patients who suffered severe acute illness from the virus, she added.

Pfizer/BioNTech vaccine safe after heart inflammation

People who have had an inflamed heart muscle in the past can safety receive the COVID-19 mRNA vaccine from Pfizer and BioNTech without causing the problem to recur, a small study suggests.

The inflammatory condition, called myocarditis, is a common complication of COVID and other viral infections and has been a rare side effect associated with some COVID-19 vaccines, primarily in young males. But among 55 patients who had recovered from myocarditis within the past five years and who later received a COVID-19 mRNA vaccine, no one suffered a repeat episode of myocarditis, researchers reported on Friday at the European heart meeting ESC Acute CardioVascular Care 2022 https://www.escardio.org/Congresses-&-Events/Acute-Cardiovascular-Care. Of the 55 subjects, 43 had received both doses of the vaccine and 12 just the first dose. Nearly all had received the Pfizer/BioNTech vaccine, so the findings may not apply to other shots, the researchers said.

Still, the results “provide reassuring data that may encourage patients with a history of myocarditis to get vaccinated against SARS-CoV-2,” study author Dr. Iyad Abou Saleh of Hospices Civils de Lyon, France, said in a statement.

Click for a Reuters graphic https://tmsnrt.rs/3c7R3Bl on vaccines in development.

 

(Reporting by Nancy Lapid and Linda Carroll; Editing by Bill Berkrot)

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Rare Cases of Monkeypox Diagnosed in Britain | Health | thesuburban.com – The Suburban Newspaper

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TUESDAY, May 17, 2022 (HealthDay News) — Four men in England have been infected with a “rare and unusual” monkeypox virus.

Investigators from the U.K. Health Security Agency are investigating the cases and whether there is any connection between the men, according to the Associated Press. None of the individuals had traveled to the African countries where the virus is endemic. Three of the men are in London, and one is in Northeast England.

Three earlier cases were announced last week. In those cases, two of the patients lived in the same household. The third person had previously traveled to Nigeria, one of the countries where the virus is endemic in animals. Most people who get monkeypox recover quickly, within several weeks. The virus has symptoms that include fever, muscle ache, chills, and fatigue. A rash similar to that found in chickenpox and smallpox can form on the face and genitals in more severe cases.

The latest four cases all happen to be in men who identify as gay, bisexual, or men who have sex with men. However, monkeypox does not easily spread between people, and it is not known to be transmitted sexually. In Western and Central Africa, the virus is typically spread by touching or being bitten by an infected wild animal. However, it could be spread among people with extremely close contact, the British health officials said.

“The evidence suggests that there may be transmission of the monkeypox virus in the community, spread by close contact,” said Susan Hopkins, M.D., chief medical advisor for the U.K. Health Security Agency, the AP reported. “We are particularly urging men who are gay or bisexual to be aware of any unusual rashes or lesions and to contact a sexual health service without delay.”

Public health officials consider the risk to the general population to be low. They are working with hospitals and international partners to determine if there is a similar rise in cases in other places. This includes tracing people who had contacts with the monkeypox cases, including airline passengers, the AP said. Doctors who see patients with unexplained rashes should seek advice from a specialist, public health officials said.

Associated Press Article

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Long COVID: Half of patients hospitalised have at least one symptom two years on – Australian Hospital + Healthcare Bulletin

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Long COVID: Half of patients hospitalised have at least one symptom two years on

Two years on, half of a group of patients hospitalised with COVID-19 in Wuhan, China, still have at least one lingering symptom, according to a study published in The Lancet Respiratory Medicine. The study followed 1192 participants in Wuhan infected with SARS-CoV-2 during the first phase of the pandemic in 2020.

While physical and mental health generally improved over time, the study found that COVID-19 patients still tend to have poorer health and quality of life than the general population. This is especially the case for participants with long COVID, who typically still have at least one symptom including fatigue, shortness of breath and sleep difficulties two years after initially falling ill.1

The long-term health impacts of COVID-19 have remained largely unknown, as the longest follow-up studies to date have spanned around one year.2 The lack of pre-COVID-19 health status baselines and comparisons with the general population in most studies has also made it difficult to determine how well patients with COVID-19 have recovered.

Lead author Professor Bin Cao, of the China-Japan Friendship Hospital, China, said, “Our findings indicate that for a certain proportion of hospitalised COVID-19 survivors, while they may have cleared the initial infection, more than two years is needed to recover fully from COVID-19. Ongoing follow-up of COVID-19 survivors, particularly those with symptoms of long COVID, is essential to understand the longer course of the illness, as is further exploration of the benefits of rehabilitation programs for recovery. There is a clear need to provide continued support to a significant proportion of people who’ve had COVID-19, and to understand how vaccines, emerging treatments and variants affect long-term health outcomes.”3

The authors of the new study sought to analyse the long-term health outcomes of hospitalised COVID-19 survivors, as well as specific health impacts of long COVID. They evaluated the health of 1192 participants with acute COVID-19 treated at Jin Yin-tan Hospital in Wuhan, China, between 7 January and 29 May 2020, at six months, 12 months and two years.

Assessments involved a six-minute walking test, laboratory tests and questionnaires on symptoms, mental health, health-related quality of life, if they had returned to work and healthcare use after discharge. The negative effects of long COVID on quality of life, exercise capacity, mental health and healthcare use were determined by comparing participants with and without long COVID symptoms. Health outcomes at two years were determined using an age-, sex- and comorbidities-matched control group of people in the general population with no history of COVID-19 infection.

Two years after initially falling ill, patients with COVID-19 are generally in poorer health than the general population, with 31% reporting fatigue or muscle weakness and 31% reporting sleep difficulties. The proportion of non-COVID-19 participants reporting these symptoms was 5% and 14%, respectively.

COVID-19 patients were also more likely to report a number of other symptoms including joint pain, palpitations, dizziness and headaches. In quality of life questionnaires, COVID-19 patients also more often reported pain or discomfort (23%) and anxiety or depression (12%) than non-COVID-19 participants (5% and 5%, respectively).

Around half of study participants had symptoms of long COVID at two years, and reported lower quality of life than those without long COVID. In mental health questionnaires, 35% reported pain or discomfort and 19% reported anxiety or depression. The proportion of COVID-19 patients without long COVID reporting these symptoms was 10% and 4% at two years, respectively. Long COVID participants also more often reported problems with their mobility (5%) or activity levels (4%) than those without long COVID (1% and 2%, respectively).

The authors acknowledged limitations to their study, such as moderate response rate; slightly increased proportion of participants who received oxygen; it was a single centre study from early in the pandemic.

References:

1. – National Institute for Health and Care Excellence – Scottish Intercollegiate Guidelines Network – Royal College of General Practitioners. COVID-19 rapid guideline: managing the long-term effects of COVID-19. https://www.nice.org.uk/guidance/ng188
2. – Soriano – JB Murthy – S Marshall – JC Relan – P Diaz JV – on behalf of the WHO Clinical Case Definition Working Group on Post-COVID-19 Condition. A clinical case definition of post-COVID-19 condition by a Delphi consensus. Lancet Infect Dis. 2021; 22: e102-e107
3. – Huang L – Yao Q – Gu X – et al. 1-year outcomes in hospital survivors with COVID-19: a longitudinal cohort study. Lancet. 2021; 398: 747-758

Image credit: ©stock.adobe.com/au/ink drop

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2SLGBTQ+ lobby group head speaks on the trauma of conversion therapy

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Although conversion therapy has now been outlawed in Canada, many are still victims causing them to go through a lot of trauma in the process.

According to Jordan Sullivan, Project Coordinator of Conversion Therapy Survivors Support and Survivors of Sexual Orientation and Gender Identity and Expression Change Efforts (SOGIECE), survivors of conversion therapy identify the need for a variety of supports including education and increased awareness about SOGIECE and conversion practices.

Also needed is access to affirming therapists experienced with SOGIECE, trauma (including religious trauma), safe spaces and networks, and access to affirming healthcare practitioners who are aware of conversion therapy or SOGIECE and equipped to support survivors.

“In January of 2021 when I was asked to be the project coordinator, I was hesitant because I wasn’t sure that my experience could be classified as SOGIECE or conversion therapy. I never attended a formalized conversion therapy program or camp run by a religious organization. Healthcare practitioners misdiagnosed me or refused me access to care.

In reality, I spent 27 years internalizing conversion therapy practices through prayer, the study of religious texts, disassociation from my body, and suppression or denial of my sexual and gender identities. I spent six years in counselling and change attempts using conversion therapy practices. I came out as a lesbian at age 33, and as a Trans man at age 51. I am now 61 and Queerly Heterosexual, but I spent decades of my life hiding in shame and fear and struggled with suicidal ideation until my mid-30s.

At times I wanted to crawl away and hide, be distracted by anything that silenced the emptiness, the pain, the wounds deep inside. I realized that in some ways, I am still more comfortable in shame, silence, and disassociation, than in any other way of being and living, but I was also filled with wonderment at the resiliency and courage of every single one of the participants.

However, many of us did not survive, choosing to end the pain and shame through suicide. Many of us are still victims in one way or another, still silenced by the shame, still afraid of being seen as we are. Still, many of us are survivors, and while it has not been an easy road, many of us are thrivers too,” said Jordan.

In addition, Jordan said conversion practices and programs are not easily defined or identified, and often capture only a fragment of pressures and messages that could be considered SOGIECE.

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